article is an update
to an earlier one
published in the NASW
Specialty Practice
Sections in which second-year
MSW students explored their
reactions to newly enacted gun
legislation (Patterson, 2013). In
this follow-up article, the first
and second authors, who were
second-year MSW students at
the time of the initial article,
provide significant contributions
based on their experiences and
observations in field placement
while completing a class
assignment.
On January 15, 2013, New
York State (NYS) Governor
Cuomo signed legislation
enacting the Secure Ammunition
and Firearms (SAFE) Act. In
summary, the SAFE Act is a
state gun law, which, among
other provisions, requires that
four mental health professional
groups report to the local
director of community services
when a client in their care is
“likely to engage in conduct
that would result in serious
harm to self or others” (Office
of Mental Health, 2013). In
NYS these mental health
professionals include physicians,
psychologists, registered nurses,
and licensed clinical social
workers (LCSWs); licensed
master social work (LMSW)
professionals are not included
in the legislation. The law took
effect on March 16, 2013, NY
SAFE Act, (www.omh.ny.gov/
omhweb/safe_act/guidance.pdf)

It is challenging for social
workers to keep up with the
abundance of literature directly
related to their own expertise in
social work practice. It is even
more challenging to understand
and make use of research from
other, potentially relevant
disciplines, such as neuroscientific
findings about brain
and behavior, social and
emotional function, and
learning and memory.

Eric Garner was an
unarmed black man.
He died after a police
officer reportedly put
him in a chokehold. At the time
of Eric Garner’s death, during
the demonstrations happening
in the streets of New York City,
one of my white colleagues
asked me what I thought social
services agencies’ response
should be to the events
surrounding Michael Brown’s
death and the protests springing
up across the country about it.
Like Eric Garner, Michael
Brown was unarmed when he
was shot by a policeman.
I was at a loss for words. My
anger at that moment was
overwhelming. I was no different
than any other mother of a black
or Latino child. I was almost
doubled over in empathetic
emotional pain for Garner and
Brown and their families. To
discuss Michael Brown, killed in
a police shooting in Ferguson,
Missouri was almost beyond me;
the reawakened awareness of
racism that had been triggered
and its ripple effects: fear,
discrimination, blame, death,
and imprisonment.

Terminally ill clients may be in
a fragile emotional state as they
face change and uncertainty at
the end of life. Dealing with
end-of-life issues can cause
anxiety, fear, and despair but
also feelings of hope and
gratitude (Bern-Klug, Gessert, &
Forbes, 2001). Psychological
distress can affect a client’s
quality of life, including physical
health. Yet in spite of these
physical and psychological
challenges, many clients
experience growth toward selfactualization
at the end of life,
inspiring those around them in
the process (Herbst, 2004;
Zalenski & Raspa, 2006).

“I do wish we had been
saving more and had a
good insurance policy in
place. I will be in serious
financial problems if my
husband passes away before I
do.” This was the heartfelt
concern shared by a 72-year-old
wife and caregiver of a hospice
patient who was dying from
advanced cancer. Unfortunately,
her experience is not uncommon.
Many families report mounting
medical debt, reduced income,
and other sources of financial
burden when coping with a lifethreatening
illness. In fact, nearly
a third of U.S. families dealing
with an end-stage illness report
having spent all or most of their
savings. Furthermore, when
compared to residents of other
industrialized countries,
Americans have the highest outof-
pocket costs for end-of-life care
and rank poorly in terms of
financial burden on patients (31
out of 40 countries; Economist
Intelligence Unit, 2010).
Although economic stress and
strain felt by families during
terminal illness is widely
recognized as a common
problem by social workers and
other health care providers, few
studies have focused on the
financial burden experienced by
families—and no research has
rigorously tested an intervention
to minimize such burden. These
gaps in the evidence base have
led researchers at the University
of Maryland School of Social
Work to examine the
complexities of financial burden
at the end of life and to develop
an intervention to reduce this
burden.

INTRODUCTION
Access to professional journals
is often very limited for social
workers following completion
of their university degrees, a
condition that makes it
challenging to meet the ethical
obligation to practice in an
evidence-informed manner
(NASW Code of Ethics, 4.01,
b and c). Fortunately, many
helpful online resources are
available that put at their
fingertips reviews of research,
relevant program evaluations,
and additional content that can
inform practice. Included in this
article are descriptions and
links to websites that are highly
credible and relevant for child
welfare practice with the birthto-
age-five (0–5) population as
well as with older children and
adolescents.
Search efforts carried out for
this article netted resources
related to parenting training,
specific programs funded by
the U.S. Children’s Bureau for
the 0–5 group, instruments to
assess child well-being for the
0–5 group, and collaborations
between schools and child
welfare to promote school
readiness.
Below are four web-based
resources, with descriptions of
the sites’ organization and
examples of content.

Palliative care is more than pain
and symptom management for
persons with serious illnesses. A
key component of palliative
care is the support provided to
patients and families, helping
them to understand their options,
clarifying goals, and linking
them to the right kinds of care
at the right time. As part of an
interdisciplinary team, palliative
care social workers play an
important role by facilitating
difficult conversations between
physicians and patients,
helping guide patients and
families through the course of
their illnesses, and linking them
to hospice when it is time.
When a patient is initially
diagnosed with a serious, lifethreatening
condition, the
treating physician is focused on
education about the disease
and treatment; however, upon
hearing a terminal prognosis,
patients and caregivers often
become internally focused
about the future ramifications of
dying and death, and therefore
may have an inadequate
understanding about the
likelihood of death or an
overestimation of survival.
Addressing emotional stressors
while concurrently assisting
with optimizing health literacy
and goal clarifications are
important interventions for the
palliative care social worker.
As such, one of the role’s most
challenging aspects is helping
patients and families balance
the hope of treatment with the
reality of probable future needs
in the face of a terminal illness.

WHAT SOCIAL
WORKERS
SHOULD KNOW
About the School to-Prison Pipeline:
A True Story

Dwayne Powe Jr. was suspended
in the eighth grade. He didn’t
get into a fight. He didn’t steal
anything. He didn’t have any
drugs. He didn’t break any
laws or rules of student
conduct. He asked for a pencil.
Powe reports that his class
began an exercise, and after
realizing he was missing a
pencil, he asked to borrow one
from another student. The
teacher told Dwayne that he
was being disruptive and asked
him to leave the classroom.
When Powe explained that he
was only asking for a pencil, it
made matters worse.
“All I was doing was asking for
a pencil, so I got suspended for
two days for willful defiance,”
Powe explained. “Because I
was just trying to ask for a
pencil.” (In 2014, 200,000
California students were also
suspended for “willful
defiance”). Willful defiance is a
discretionary term that school
personnel can use to have
students removed for being
disruptive, insubordinate, or
defiant. It is the most common
reason cited for suspensions in
California public schools, and it
is disproportionately applied to
the most vulnerable youth (Bott
& Chandler, 2015).

EDUCATING SOCIAL WORKERS
and Improving Practice with
Military Personnel and Families

NASW is committed to ensuring
practitioners have the available
resources to adequately meet
the needs of military personnel
and their families. In keeping
with social work values and
ethical standards of cultural
competenceand social justice,
it is fitting to consider service
members and the culture in
which they live and work.
Continuing education,
enrichment trainings, and even
certification are available to
help social workers work with
military families through our
professional organization.
Social workers in MSW
programs wanting to work with
service members have few
academic resources. Because
social workers must earn the
degree, complete supervision,
and direct practice hours to be
eligible to take a licensure
exam, it behooves us to focus
on the graduate-level education
that social workers receive. In
2010, the Council on Social
Work Education (CSWE) posted
a self-reported preliminary list of
current social work programs
that have military social work
curricula. With more than 660
accredited programs and
schoolsof social work programs
in the United States, there were
only 26 schools listed as having
military social work specialty
programming (CSWE, 2010).

Being deployed into war zones
exposes military men and
women to extreme adversities
that generally cause them
varying degrees of stress
(Bartone, 2006; Meichenbaum,
2011). According to Lupien,
McEwan, Gunnar, and Heim
(2009), constant exposure to
stress or stressful situations
affects the structure and function
of an individual’s brain. More
specifically, mental disorders
have been found to be related
to stress exposure, together with
timing and the genetic makeup
of individuals. For people in the
military, especially those
exposed to wars and combat,
the severity of the effect of
combat stressors may be
measured by the cases of
physical, mental, and emotional
disorders experienced by war
veterans upon returning from
war zones (Bartone, 2006).

The 2002–2006 National
Center for Health Statistics, the
National Death Index, and the
VA National Patient Care
Database show that the rates of
suicide among active-duty
military personnel and veterans
are more than double that of
the general population in the
United States. The Suicide
Mortality Report examines rates
among the Veterans Health
Administration (VHA) patient
care and the general population
by age, gender, substance
usage, mental health, access to
services, utilization of services,
and increased knowledge of
firearms. According to the
Centers for Disease Control and
Prevention’s National Injury
Mortality Data in 2004, “suicide
was the 11th leading cause of
death in the United States, third
among individuals 15 to 24.
The report compares depression
levels and suicide rates in all
50 states and the District of
Columbia (p. 1).” The National
Injury Mortality Data ranked
Florida at number 14 for
depression levels and 33 for
suicide rates based on the
number of completed suicide
deaths. The intent of this
overview is to raise awareness
based on the most current
statistics available to answer
the question: Are suicide rates
among active-duty military
members and veterans declining,
or are the numbers on the rise?
As a result of the question, the
goals are to ensure treatment
providers know the warning
signs to indicate when a veteran
may be at high risk for suicide,
and when indicated seek
immediate medical or mental
health intervention. On one
hand, veterans have additional
risk factors to which the general
population may not have been
exposed; such factors increase
veterans’ vulnerability to
depressed states. Conversely,
protective factors help offset
risks and play a key role in
helping the veteran manage his
or her current emotional state
and daily life. The review of
effective prevention and
intervention strategies provides
a solid foundation to consider
evidenced-based treatment
approaches and to explore
new breakthrough treatments
for suicide prevention.

In their classic article, “Resident
Guests: Social Workers in Host
Settings,” (Dane and Simon,
1991) captured the attention of
social workers who work in
organizations dominated by
people who are not social
workers. Since school social
work began more than 100
years ago, we have been
working as resident guests in
host settings or organizations
whose mission is the education
of children. Many school social
workers often experience
frustration and problems working
in the host setting of the school
because the professional
education system is significantly
different from the profession of
social work. Because social
work is not the primary mission
of the education system, social
workers are often viewed as
auxiliary or support staff. Social
workers who are first employed
within the school system often
bring a different orientation
and expectation regarding their
role in the school setting. In my
experience, social workers with
backgrounds in highly clinical
settings often struggle initially in
schools with role definitions, as
school social workers do so many
other tasks in schools beyond
the direct service component. In
addition, the education field
has a different professional
language, and it takes time to
learn the definitions and
implications of the terminology.

STUDENT REFLECTIONS ON
Being an Intern
with a School
Social Work
Field Supervisor

Many school social workers will
make a decision about becoming
the field supervisor for a nearby
social work program. For many
supervisors, this is a wonderful
opportunity to pass on the skills,
knowledge, and resources
necessary to be an effective
school social worker. Because
school social work is so
specialized and demanding,
care needs to be taken with
interns placed in schools. Little
has been written about what
social work students need when
they enter school as an intern.
Two students—one placed in urban school with socioeconomic
disadvantages and the other in
a specialized school that serves
behaviorally challenged
students—both reflect upon their
individual intern experience.
Their comments will be helpful
to those of you who serve or
are interested in becoming field
instructors to MSW students.

Caroline* was born and
raised in rural Mississippi.
She has memories of
eating home made grits,
cornbread and buttermilk
chicken. She remembers having
few toys, old clothes and not
many friends but that didn’t
matter because she had her
mother. She spoke about how
they did everything together,
including her most favorite
memory, making dinner
every night.
...

The use of electronic cigarettes
has skyrocketed in the United
States and globally, especially
during the past year. Sales
have moved from a primarily
Internet base to a retail base,
reaching well over $1 billion
this year and projected to
double during the next
(Robehmed, 2013). These
products are being touted as a
safe alternative to smoking and,
by some, even as a way to quit
smoking. Though neither a
tobacco product nor an
approved cessation device,
they are becoming increasingly
popular and available, and
their use and recognition has
escalated in recent years.
Online sellers, pharmacies,
convenience stores, and even
the big three tobacco
companies are staking their
claim in this growing market,
and it appears to be panning
out for them, even though they
can’t fully know what they’re
getting into or what the
outcomes will be.

REDUCING TOBACCO-RELATED
Health Disparities Among Individuals
with Psychiatric and Substance
Use Disorders:
Social Work’s Contribution

This year is the 50th anniversary
of the release of Surgeon
General Luther Terry’s report on
smoking and health. In the
intervening decades, the per
capita consumption of cigarettes
has declined by 72 percent
and the prevalence of smoking
among adults has decreased by
more than 50 percent (Lushniak,
2014). Unfortunately, individuals
with mental illness and substance
use disorders have not been
part of these improved health
outcomes. In fact, individuals
with psychiatric and substance
use disorders account for
approximately 200,000 of the
440,000 deaths each year
caused by smoking-related
problems (Mauer, 2006;
Schroeder & Morris, 2009).
These individuals make up
about 44 percent of the U.S.
tobacco market (Lasser et al.,
2000). Some estimate the rate
of smoking among individuals
with psychotic and substance
use disorders to be as high as
90 percent (Degenhardt, Hall,
& Lynskey, 2001; De Leon &
Diaz, 2005; Grant, 2004;
Krejci, Steinberg, & Ziedonis,
2003; Marks, Hill, Pomerleau,
Mudd, & Blow, 1997). These
individuals die 25 years earlier
than the general population
(Brown, Inskip, & Barraclough,
2000; Colton & Manderscheid,2006; Dixon, Postrado,
Delahanty, Fischer, & Lehman,
1999; Hurt et al., 1995:
Joukamaa et al., 2001; Mauer,
2006; Osby, Correia, Brandt,
Ekbom, & Sparen, 2000).

The field of health social
work has been well
established for many
years. However, pediatric
and adult health social workers
often exist in parallel clinical
worlds, having little interaction,
and not benefiting from lessons
learned in sister practices. This
editorial will explore the
similarities and differences of
the health social work practices
as they relate to clinical
evidence-based practice,
utilization management roles,
and relationships with primary
care givers and community
agencies. It will also showcase
the opportunities for crosssystem and interdisciplinary
approaches in which social
workers play a key role.
..

The two years leading up to the
publication of the Diagnostic
and Statistical Manual of Mental
Disorders, 5th edition (DSM-5;
APA, 2013), in May 2013 have
been described as a “war…that
has shaken psychiatry to its
core” (Greenberg, 2013, p. 3).
The chair of the DSM-IV task
force, Allen Frances (2013),
publicly decried the process
and cautioned that the changes
in DSM-5 would “turn our
current diagnostic inflation into
hyperinflation by converting
millions of ‘normal’ people into
‘mental patients’” (p. 3). The
value of the DSM-5 as a “bible”
for mental health practitioners
was further questioned when
Thomas Insel (2013), director
of the U.S. National Institute of
Mental Health (NIMH) published
a blog post in which he said,
“[Mental health research]
cannot succeed if we use
DSM categories as the gold
standard… That is why NIMH
will be reorienting its research
away from DSM categories.”
By the time the DSM-5 was
published in May 2013, it
seemed quite possible that the
addition of 15 new diagnoses
and the reorganization of
psychiatric diagnoses would
lead to a disaster of epic
proportions...

A DSM revision occurs roughly
every 10 years, with the hope
of integrating advances in
empirical research to increase
the reliability, validity, and
clinical utility of the diagnosis
of mental health disorders.
Although every revision has been
faced with some controversy
(Lacasse, 2013; Pomeroy &
Parrish, 2012), the process of
developing DSM-5—viewed by
many as nontransparent and
lacking sufficient empirical
support—has received more
criticism from various behavioral
health disciplines than earlier
revisions (Frances, 2013;
Washburn, 2013). Despite this
controversy, DSM-5 is now in
press (APA, 2013b) and
continues to be widely used
in medical and social service
settings and for the
reimbursement of mental health
services. As such, to ensure that
social workers and other service
providers continue to speak the
same language, it is essential
that we become familiar with the
changes to DSM’s organizational
structure, the inclusion and
exclusion of specific diagnoses,
and the new diagnostic labels
for existing diagnoses. The
purpose of this summary is to
highlight key revisions to the
diagnostic system and briefly
discuss the implications of
these changes for children,
adolescents, and their families....

All modern organizations, as
never before, are in need of
competent managerial leaders,
who bring more than their
technical abilities. They require
people who can survive and
help organizations prosper in
a world of constant change
and intense competition.
Organizations need leaders
with both technical competence
and interpersonal excellence
(Edwards &Yankey, 2006).

PRESIDENT OBAMA NOMINATES
THREE TO DC CIRCUIT COURT:
Why Should Social Workers Care?

has been widely reported that
President Obama has taken the
extraordinary step of nominating
three individuals to fill the
remaining vacancies of the U.S.
Court of Appeals for the District
of Columbia Circuit (also known
as the D.C. Circuit Court) This
step is extraordinary because:
(1) There is a critical need to
fill all the vacancies on this
important court and (2)
submitting multiple nominations
is a White House strategy to
protect against filibustering
against the President’s judicial
nominees.
President Obama’s Nominees
The three nominees include
highly qualified candidates
who are diverse in terms of
gender and ethnicity. The
nominees are:
Patricia Ann Millett, a white
woman who is an a prominent
appeals lawyer in Washington,
D.C., Cornelia Pillard, a white
woman who is currently a highly
regarded law professor at
Georgetown University, and
Robert Leon Wilkins, an African
American man who was
appointed to the United States
District Court for the District of
Columbia in 2009. Judge
Wilkins successfully argued a
milestone racial profiling case
(Wilkins v. Maryland) in 1994
(http://judgepedia.org/index.
php/Robert_Leon_Wilkins).

BOOK SUMMARY: Social Work Documentation:
A Guide to Strengthening Case Recording

When asked to review a book
about social work documentation,
I must admit my initial thoughts
were not embracing of the
prospect of reading about
documentation. Having given
related trainings in a variety of
contexts, with students and
colleagues, and across
interdisciplinary settings; eyes
glaze over. This book review is
for “Social Work Documentation:
A Guide to Strengthening Case
Recording” published in 2011
by the NASW Press. Nancy L.
Sidell, PhD, the author, thanks
numerous people and shows
that documenting her book was
truly a group process. Among
her accomplishments, Dr. Sidell
is chair of the Social Work
Department at Mansfield
University in Pennsylvania,
has authored numerous journal
articles, and has practiced in
a variety of settings for two
decades. A cursory review of
professional literature in the field
is included in this book, as well
as a variety of NASW Press
pamphlets on confidentiality,
privileged information, the Code
of Ethics and Standards of
Practiceseries.
Sidell’s organization of the
book and its topic areas are
well-laid out for the reader.
Attention to documentation is
critical to the future of our
profession; supervisors and
teachers should take note to put
more emphasis on assisting
students and interns with their
writing skills. The book’s
audience covers a wide
continuum of social workers.
Sidell’s accuracy is spot on – it
is quite difficult to capture
everything because social
workers provide so many
different services. She addresses
the global areas which all social
workers will need to document,
while still accounting for the
unique ways various settings must
document distinct information.

Social workers in schools are
typically called to be advanced
generalists, and responding to
eating disorders should be
among their many competencies.
School social workers and
support staff must be aware of
the common signs of eating
disorders and take precautions
to protect the students in their
schools. Eating disorders can
present serious physical and
emotional obstacles to learning.
They also have the highest
mortality rate among all mental
disorders (Galson, 2009; Keel
& Herzog, 2004). According to
the South Carolina Department
of Mental Health, 95 percent of
the individuals with eating
disorders are between the ages
of 12 and 25 (South Carolina
Department of Mental Health,
2006)—a statistic that verifies
students’ higher risk for eating
disorders. Therefore, such
disorders should be a particular
area of concern for school
social workers.

Do social workers find joy in
their work? If so, how? As three
curious professors of social work,
we set out to investigate these
questions. Our curiosity was
sparked by our interest in
positive psychology (e.g.,
Peterson, 2006; Seligman &
Csikszentmihalyi, 2000) and
appreciative inquiry (AI; e.g.,
Cooperrider & Whitney, 2005),
newly emerging practice fields in
psychology and organizational
development, respectively. In
contrast to psychology’s
traditional emphasis on
pathology, positive psychology
is concerned with individual,
organizational, community, and
societal experiences that relate
to health and well-being,
contentment, satisfaction, flow,
happiness, hope, and optimism.
This perspective focuses on the
study of what makes life worth
living, how individuals make
meaning and purpose out of
their lives, and how institutions,
such as workplaces, foster
satisfaction among its members.
AI focuses on a search for the
best in people and on what
gives life to human systems.
Simply put, AI purports that
what we as humans focus on
and pay attention to is what
expands in our lives. In other
words, focus on what is going
well and that is what grows in
us. Focus on pathology and
problems, and these negatives
will multiply in our lives.

CREATING A STANDARD PROTOCOL
for Domestic Minor Sex Trafficking
Victims: How Child
Welfare Workers Can Better
Facilitate Protections Under
the Guise of the TVPA

The Trafficking Victims Protection
Act (TVPA) of 2000 and its
subsequent reauthorizations in
2003, 2005, and 2008 were
implemented to combat
trafficking in persons (H.R. 2620
[2003]; H.R. 972 [2005]; H.R.
7311 [2008]; Public Law [P.L.]
106-386). Specific to minors,
the act definitively stipulates that
any person under 18 years of
age who is induced to perform
a commercial sex act is a victim
of a severe form of trafficking
(P.L. 106-386). Shared Hope
International has coined the term
“domestic minor sex trafficking”
to describe this phenomenon.
The intent of this paper is to
discuss how the tenets of the
TVPA can be used by workers
in the child welfare arena as a
conduit for creating a standard
protocol for domestic minor sex
trafficking (DMST) victims.

As the war in Iraq winds down
and troops withdraw from
Afghanistan, thousands of
veterans are leaving the
military and seeking jobs in the
public and private sectors. For
social work administrators and
supervisors, this can be a rich
opportunity to fill positions with
individuals who have developed
unique skills through life
experience and training, and
who have demonstrated an
ability to perform under pressure
and engage in a greater cause.
When hiring returning veterans,
it is important that the
workplace is welcoming and
sensitive to their military
experience and that staff have
been trained to interact
appropriately in terms of
questions to ask and statements
to make—particularly if the
veteran has returned to civilian
life with a disability.

Many studies have indicated
that veteran benefits are
underutilized, but few studies
reveal how much veterans and
their spouses know about these
benefits. Veterans and spouses
of veterans may be eligible for
a number of veteran benefits
that they know little about. In
this study, a survey was
distributed to seniors in five
Wesley Enhanced Living
retirement communities in
southeastern Pennsylvania. In
total, 137 (n = 137) veterans
and spouses of veterans formed
the sample for the study. The
purpose of this study was to
determine the knowledge base
of senior veterans and their
spouses regarding veteran
benefits. It also explored which
benefits this population would
like to learn more about.
Findings suggest that most of
the senior veterans and spouses
lacked knowledge about
veteran benefits like health
care, prescriptions, serviceconnected disability, pension,
education and training, home
loan guaranty, life insurance,
burial and memorial benefits,
transition assistance, and
dependent and survivor
benefits. The implications of this
study on future practice with
veterans and spouses of
veterans are also discussed.

It is reported that African
Americans tend to be less likely
than whites to seek therapy
when struggling to resolve
psychological and emotional
problems. One reason why
African Americans do not seek
out therapy is the stigma
surrounding mental health.
Many do not want their peers
knowing that they sought out
mental health services. Research
also supports the claim that
African Americans who are
low-income and depressed are
more inclined to deny needed
treatment while others who do
receive help have a high chance
of terminating treatment
prematurely. In addition,
sometimes complaints are
misrepresented as somatic
rather than emotional resulting
in undetected depression.
Collectively, all these findings
indicate that many African
Americans who suffer from high
rates of depression do so
undetected and untreated, a
clear public health concern.
(Center for Addiction and
Behavioral Health Research)

At 2:50 pm on April 15, 2013,
the joyous scene at the finish
line of the Boston Marathon
was shattered by an explosion,
which was followed moments
later by a second blast. After
being contacted by Boston
Emergency Medical Services
with a request for disaster
capability, Massachusetts
General Hospital (MGH)
activated its Incident Command
Center to mobilize resources in
preparation for an influx of
patients and families. Less than
15 minutes after the explosions,
the first patient arrived at MGH;
30 more followed that afternoon.
MGH Emergency Department
(ED) social workers leapt into
action. MGH is a level-one
trauma center, and social
workers there engage in
trauma work on a daily basis,
but the aftermath of the
marathon bombings involved
far higher levels of acuity.
Confronted by a large number
of severely injured patients who
needed to be triaged quickly,
ED social workers had little time
to contribute to patient care in
customary ways (for example,
provide crisis intervention and
counseling). Instead, they
collaborated with the health
care team to identify patients
while fielding phone calls from
worried loved ones in search of
friends and family. One ED
social worker related that there
would have been “no way to
prepare for the sensory
overload” she experienced.

THE IMPORTANCE
OF DEVELOPING
COLLABORATIVE
Relationships
Between Spiritual
Care Professionals
and MSW Interns

INTRODUCTION
This is a reflective
discussion about the
collaborative
relationships developed between
a board-certified chaplain and
several clinical social work
interns at City of Hope (COH).
The purpose is to highlight the
importance of developing such
vital relationships so that MSW
interns learn about the full
spectrum of spiritual care
services while they are finetuning their clinical tools. Clinical
internships such as the ones
described here are “the last
classroom” before these
graduate students complete their
MSW degrees and launch into
the dynamic environment that
defines their future vocations.
This discussion is offered in the
hope that other hospitals will
be encouraged to support
interprofessional education.

What is new in the DSM-5, why
was it changed, and why are
some of the changes so
controversial? In part 1 of this
three-part review of the DSM-5,
I surveyed changes in the
metastructure and organization
of the manual, including the
elimination of the multiaxial
system and the regrouping of
disorders in a different chapter
structure. I then began a highly
selective survey of some of the
most controversial new
categories and the most
important changes to the
diagnostic criteria for existing
categories. In part 2, I complete
my selective survey. In a
forthcoming part 3, I will
consider in more detail the one
area where changes have
garnered the most controversy:
depressive and grief disorders.

The Internet and social media
offer social workers
unprecedented opportunities
to educate communities, to
advocate for disadvantaged
populations, to raise awareness
about their private practice and
professional services, and to
establish themselves as experts
in their specialty areas. Because
people search online for health related information, developing
a strong online presence is
increasingly important for social
workers in private practice.

In a society that relies on the
newest technology, takes
medication for everything, and
seeks immediate gratification,
how often do you have your
clients just stop and think outside
the box? How often do you
engage them physically as well
as emotionally when searching
for the answers to their issues?
And how often do you use a
1,200-pound animal to provide
those answers more clearly?

SCHOOL SOCIAL
WORKERS AND
VICARIOUS
TRAUMA:
Creating Tools for
Building Resilience
in the Workforce

Social workers in all
settings are increasingly
caring for survivors of
trauma who have faced
a variety of experiences,
including interpersonal violence,
community disruptions, natural
disasters, and war (Sommer,
2008; Trippany, Kress, &
Wilcoxon, 2004). Child
maltreatment has become a
major problem in the United
States (Lawson, 2009). Children
with disabilities are even more
likely to experience abuse at the
hands of those designated to
provide them with a safe and
nurturing environment
(Herskowitz, Lamb, & Horowitz,
2007). The high likelihood that
school social workers will be
exposed to trauma through their
work makes adequate training
and education about the effects
of the work on the worker a
necessity. Additionally, given
that the number of social workers
in schools has been inadequate
to meet the rising need to
address mental health issues in
children, we can understand
how many school social
workers struggle with job
satisfaction and feeling supported
in their work (Agresta, 2006).
To support school social
workers, education must keep
pace with changes in the
practice setting (Berzin &
O’Connor, 2010), and the
focus must be on professional
resilience in the face of
vicarious trauma. Appropriately
addressing vicarious trauma
will improve the well-being of
school social workers so that
they can effectively provide
services to children and their
families. This benefits schools
and the community at large,
because addressing vicarious
trauma would bolster much needed retention efforts in the
face of burgeoning demand
and high turnover.

WHAT ABOUT THE BOYS?
Should the High Drop-Out Rates
and Over representation of Boys
in Special Education Be of Concern to School Social Workers?

A proliferation of books and
articles regarding boys has hit
the market in recent years. Boys
today are in crisis. The tragedy
of school violence across the
nation raises a growing concern
regarding boys who publicly
act out their social and emotional
disconnection through acts of
violence against themselves or
others. Many boys who do not
act out, silently struggle with
feelings of loneliness, isolation,
and depression. As a school
social worker and a professor, I
have always wondered how we
should consider boys’ lives more
directly and thoughtfully. I have
observed through my clinical
work and numerous school
program consultations how
dramatic the problems are for
boys. We all have considerable
investment in how our society
describes and socializes boys
to become men. In recent years,
controversy about boys, men,
and education has emerged on
several fronts. A proposal to
establish boys-only schools in
Detroit and other major U.S.
cities provoked strong reactions,
but was halted in the end by
ensuing legal action. Other cities
like New York are embracing
single-sex charter schools for
inner city youth to help boys
develop without the presence of
their female counterparts. Many
schools are launching special
programs for boys without the
benefit of research to guide them,
often lacking careful thinking
about what they hope to
accomplish as an end product.
Asserting that boys need
advocacy tends to generate
controversy. In recent years, the
media and the academic
community have focused their
discussions of fairness in
schools almost exclusively on
girls and the ways they have
been short-changed in a system
that favors boys. In her book
titled The War Against Boys: Harming Our Young Men,
Christina Hoff-Sommers (2000)
counters this argument but
highlights the controversy. Often,
the sexes are pitted against one
another as to who should receive
special attention in schools and
other major social institutions.
Authors such as Mary Pipher
(1994) in Reviving Ophelia
revealed the difficulties of
growing up female. We now
know that girls lose their true
identity as they enter into their
adolescence because of society’s
gender stereotypes about girls.
The real challenge is whether the
public schools and society have
responded in an appropriate
manner to meet the needs of
both sexes.

Substance abuse has costly and
wide-ranging impacts on society.
Since the days of the Puritans, it
has been recognized as a
substantial societal problem in
our country, and the dangers
posed to society from the use
and abuse of alcohol, tobacco,
and other drugs are severe
(Corrigan, Bill, & Slater, 2009;
Smith, Whitaker, & Weismiller,
2003). Because social workers
are routinely asked to intervene
in societal troubles, they often
constitute the first line of defense
and the first direct contact with
those who abuse substances.
This interaction occurs in various
service delivery systems—
community-based services,
child welfare, medical settings,
and employee assistance
programs (Smith et al., 2003).

What do you think about the
doctors you visit? Do you fully
trust them with your health
care? Do you seek second
opinions before treatment or
surgery? Individuals born after
the boomer generation will
likely research the medical
condition and ask for second
opinions before any procedure
or surgery. They usually get
answers to their questions
before taking action. Therefore,
their belief, experience, and
knowledge about the medical
condition, doctors, and the
medical profession in general
influence the action taken. This
may not be true for older adults
seeking health care answers. The
following examples demonstrate
the interaction patterns between
adults over the age of 75 and
their physicians regarding their
health care.

DSM-5 — the fifth edition of
the American Psychiatric
Association’s Diagnostic and
Statistical Manual of Mental
Disorders — is here. This is
an exciting time for clinicians.
The DSM-5 revision process
created an opportunity for open
discussion of the nature of our
patients’ problems and how
best to conceptualize them. This
resulted in controversies that
became so heated that some
critics went so far as to suggest
that the DSM should be
abandoned altogether in
favor of the World Health
Organization’s diagnostic
manual, the International
Classification of Disease
(ICD), from which the DSM’s
diagnostic codes are taken but
which lacks the DSM’s detailed
diagnostic criteria.

INTRODUCTION
Violence in the workplace
continues to be a critical issue
in this country for a wide range
of workers who serve the
general public, including
convenience store clerks, cab
drivers, teachers, nurses, and
social workers. Violence
actually happens relatively
rarely, with, of course, some
exceptions. Because the odds
are usually in favor of violence
not occurring, social workers
can have a false sense of
security and not take
precautions necessary to
ensuring their safety. When
violence does occur, the effects
can be devastating. Incidents of
client violence toward social
workers, including quite serious
ones, are continuing to occur.
Literature confirms that client
violence toward social workers,
both nationally and
internationally, does occur and
warrants action and concern.

The Internet used to be a
storage locker of information,
but now it is dominated by
more conversations than anyone
could ever have imagined a
few years ago. The unique
“interactive dialogue” that is
instant messaging (IM), blogging,
Facebook, Twitter, LinkedIn,
email, Skype, and smart phone
apps constitutes the current
group of the most popular social
media communication tools.
Most social work supervisors
probably have some
knowledge of them, but they
might not be actively using them.

GERIATRIC SOCIAL WORKERS:
Preparing for the Implementation
of the Affordable Care Act

The Affordable Care Act (ACA)
was signed into law in 2012
and is set to be implemented in
January 2014. Many states are
currently preparing for what
appears to be a major change
in our current health care
services. It is anticipated that
many changes will affect
current private insurance,
Medicare, Medicaid (MediCal
in California), and dual benefits
for those who receive both
Medicare and Medicaid. In
many cases, it is not unusual for
many health care plans to
begin implementing some
aspects of the ACA, such as
providing preventive health
services with no co-payment in
preparation for this policy
change. The key issue is for
geriatric social workers to be
prepared for changes and the
effects they may have on our
current methods of practice.

Despite crisis being usually
understood as an expected and
disruptive event, the Chinese
translation of the word “crisis”
consists of two separate
characters: 危and 機. The
word 危usually means
“danger.” Also, it can mean
unsafe, disaster, or even death.
The word 機has several
different but connected levels of
meaning. 機can refer to
significant turning points or
things that can be turned or
moved. In addition, there is a
time dimension to it, signifying
that it is the right time to take a
different course. The word 機
also has an action dimension
that describes a sense of
quickness to seize the
opportunity for positive change
or to go with the tide of
change. Taken together, the
Chinese translation of the word
“crisis” is fascinating because
of the polarized process being
described: crisis can potentially
be a time of danger, unsafe,
disaster, or even death. The
other side of it, however, is
exactly the opposite of danger:
it is a turning point—the exact
right time—for positive change
that requires quickness and
flexibility to flow with the change
process. In some ways, the
meaning of crisis coincides with
that of the yin-yang symbol: the
presence of two seemingly
opposite but closely connected
parts of a phenomenon.

have responded to many
tragedies in my career—both
natural and human caused—
but the Newtown, Connecticut,
tragedy, or “12-14” as many
local residents refer to it, has
shaken my confidence and faith
about what I and others can do.
Perhaps it is the sheer horror of
trying to empathically imagine
young children being shot
multiple times at point-blank
range, or the images that are
carried by survivors, or what it
was like for responders as they
entered the scene of this
catastrophe. This is a challenging
situation to engage with in our
imaginations, let alone respond
to, even for the most seasoned
of social workers.
And yet when I think of the
teachers who gave their lives
trying to protect children and
the courage of the parents,
siblings, classmates, teachers,
friends, neighbors, and others
who have come together to
support one another, to pick up
the pieces of shattered hearts,
and to work to repair a torn
community, I can begin to
regain a sense of hope: hope
about the human capacity to
survive even the most alienating
and tragic circumstances
imaginable and hope about the
“better angels of our nature”
(Pinker, 2011) being able to
transcend the forces of
destruction that all human beings
are capable of harboring. And
hope is precisely what people
who have been touched by this
tragedy sorely need. I do not
mean hope in the sense that we
quickly move on to something
else or that we minimize the
wounds and scars that many will
carry for the rest of their lives; I
mean hope in our capacity as
human beings to reconnect with
one another and to rebuild our
lives—as changed as they may
be—and to work to transmute
heartbreak into sources of
meaning and inspiration.

In 1980, armed with nothing
more than good intentions and
big dreams, my husband and I
walked into our local adoption
agency and announced that we
wanted to adopt a child.
Because I was carrying our sixweek-old baby in my arms, our
request was met with looks of
surprise and even incredulity.
Clearly—although we were
quite young—we were not the
infertile couple seeking a
newborn baby that the agency
was expecting when they made
our intake appointment. The
social worker who interviewed
us began by asking what type
of child we thought we might
want to adopt, and we were
ready with our answer: “a child
most in need of a home…and
least likely to get one.”

What caused the United States
to start focusing on bullying? I
wish I could say my own
interest in this subject began in
adulthood, as a concerned
social worker, but the reality is
that I, like many of you, was
bullied in my youth. During the
past decade, hardly a week
has gone by when I haven’t
read or heard of a violent
tragedy befalling a family in
America. I can recall exactly
where I was more than 10
years ago, on April 20, 1999—
I was talking with a colleague
in her office in the juvenile
division of the family court—
when I heard the radio
announcer report on the events
unfolding in Columbine,
Colorado. Investigators
eventually learned that Eric
Harris and Dylan Klebold—the
two high school students who
went on the shooting spree that
killed 12 classmates, a teacher,
and then themselves—endured
years of bullying. They had left
suicide notes that called their
actions a “revenge killing” to
get back at those who had
bullied them for years. As an
adult, I am most concerned
about how the nature and
methods of bullying have
intensified. The rise of the
Internet and electronic
communications laid the
groundwork for epidemic levels
of hurtful rumor. Access to
weapons added fuel to the fire.
I am struck by what has—and
has not—changed about youth
violence in more than 10 years.
Before I sat down to review and
edit this article, I opened the
newspaper, as I do every
morning, to find headlines once
again related to our American
violence trifecta: bullying,
mental health, and gun safety.

NEW YORK Secure Ammunition
and Firearms Act (SAFE) of 2013:
Implications for Social
Work Practice

The New York Secure
Ammunition and Firearms Act
(SAFE) of 2013 is among the
toughest state gun laws in the
country and the first to pass
both the state house and senate
since the fatal school shooting
in Sandy Hook, Connecticut.
New York State Governor
Cuomo signed SAFE into law
on January 15, 2013. Among
the provisions of this legislation
are: limits on the ability for
individuals convicted of felonies
to obtain a firearm; limits for
individuals with mental illness
who are assessed as dangerous
to access weapons; a ban on
high-capacity rounds, limiting
any magazine that holds more
than seven rounds; a
requirement for immediate
background checks on all
ammunition purchases,
required tracking of
ammunition purchases as they
occur; a requirement for
individuals to recertify their
handguns and assault weapons
every five years, requiring
universal background checks
even at private sale events;
imposing a mandatory penalty
of life in prison without parole
for killing a first responder in
the line of duty; safe storage
requirements for weapons; a
penalty for possessing a
weapon on school grounds;
tougher penalties for illegal gun
use; a requirement for judges
issuing orders of protection
when victims feel perpetrators
will use a gun to demand that
perpetrators surrender the
weapon; extending Kendra’s
Law for two years, through
2017, as well as extending the
period of mandatory outpatient
treatment from six months to
one year; and requiring
assessment prior to releasing
an inmate with mental illness.

Presently, our country is in the
midst of another extended
reflection upon what it is to be
an American. More specifically,
our leaders in Congress are
reexamining our national
policies with regard to
immigration, and the Supreme
Court is deliberating on the civil
rights of the LGBT (lesbian, gay,
bisexual, and transgender)
community. As the national
dialogue continues, professional
social workers have a duty to
engage in this discussion, which
has many implications for our
clients, our organizations, and
our communities (NASW, 2009).
I am an associate professor at a
comprehensive public university
in northern California that
largely serves a rural geographic
region. One of my academic
duties is teaching general
education courses as well as
major specific courses to
undergraduate and graduate
students enrolled in our BSW
and MSW programs,
respectively. In my classroom, I
strive to create a safe space for
students to engage in sometimes
heated, but nevertheless civil,
discussions as we address
various concepts. One morning
I came to my university office
and found my door had been
defaced overnight with three
messages. Prominent among
these messages were a powerful
symbol and a phrase: a swastika
and the words “white power.”

THE ROLE OF HOPE in the
Journey toward Recovery for
Individuals with Mental Illness

In the 1990s, advocates of
clients/consumers, family
members, and some providers
began to challenge many of the
old assumptions and stereotypes
about mental illness and the
lives of those with mental
illness. These advocates—
some speaking from personal
experience and others from
observation—argued that
being diagnosed with a mental
illness, even a serious one, is
not a death sentence in terms of
hope for the future. Instead,
many people who have mental
illness can lead fulfilling lives
and can achieve universal
goals: friendships, romantic
partnerships, meaningful work,
enjoyable recreational pursuits,
and independent living. In other
words, many people with
mental illness can achieve
“recovery.” These advocates
soon coalesced into a recovery
movement that, over time,
succeeded in achieving a
paradigm shift with mental
health systems of care around
the world at all levels “by
challenging mental health
providers, administrators,
policy makers, funders,
workers, and the people who
experience mental health
problems and their families to
look at how negative or limiting
assumptions are driving
approaches to services, to
funding, to treatment, to
policies, and ultimately to the
course of everyday lives”
(Pennsylvania Office of Mental
Health and Substance Abuse
Services, 2005, p. 6).

Social workers are increasingly
relying on mobile communication
devices such as Internet-enabled
mobile phones (“smart phones”),
laptop computers and tablet
computers in the course of
carrying out professional social
work duties. Some of the
common issues that arise in the
use of these devices include:
• Is it okay for me to email
information to my clients?
• Am I required to use an
electronic health record for
clients?
• I’ve started storing my client
files on a remote server
through an IT vendor that
provides password access to
the records. Is that sufficient
protection for clients’
confidentiality?

As school systems become more
ethnically diverse, the need to
sensitize and train stakeholders
in those systems becomes more
critical. Increasingly, educators
find Pacific Islanders in their
student bodies without sufficient
information concerning their
background, heritage and
culture. The purpose of this
article is to begin to rectify this
imbalance with accurate data
and information.

NEUROSCIENCE AND THE 49%
RULE: How to Avoid Overworking
the Therapist and Underworking
the Patient

In the book The Talent Code,
author Daniel Coyle interviewed
UCLA Professor of Neurology
Dr. George Bartzokis. In the
interview, Dr. Bartzokis described
learning as a skill that boiled
down to three simple facts:
1-Inside the brain, every human
movement, thought, or feeling is
an electrical signal that moves
through a chain of neurons;
2-Myelin is the cellular insulation
that wraps the chain of neurons
to increase strength, speed,
and accuracy of that electrical
signal; and 3-The more you fire
the chain of neurons, the more
myelin optimizes that circuit,
making the electrical signal
stronger, faster, and fluent
(Coyle, 2009, p.32).

The strengths perspective has long recognized the importance of hope and has influenced how social
workers interact with clients by providing an alternative to the more common pathology-oriented
approach. Rather than focusing on young clients’ deficits and weaknesses, which can hinder clients’
progress, the strengths perspective believes in focusing more on clients’ strengths to help bring about
positive changes (Saleebey, 2006).

Now that 10 years of military involvement in
Iraq and Afghanistan are coming to a close,
communities across the United States are
evaluating their preparedness in terms of
services for returning combat service members
and their families. As professionals, social
workers have a unique and important
opportunity to lead the way. The challenge for
social workers, agencies, and communities is
engaging and integrating the transitioning
individual service member and family.

INTRODUCTION
Social workers may have a
general concept of immigration
requirements, but this area of
law is both complex and
volatile. U.S. laws and policies
affecting the status of
immigrants have evolved over
time in response to various
social, political and economic
pressures. More recently, in the
wake of welfare reform in the
1990s, and in the post 9/11
era, U.S. immigration policy
has returned to an exclusionary
focus that has turned toward
conflating criminality and
undocumented immigration
status. Although immigration
laws are within the exclusive
purview of the federal
government, a number of states
have attempted to address
concerns about violations of
immigration law by residents by
passing various exclusionary
measures. This may create legal
questions and ethical dilemmas
for social workers who work in
programs or areas serving
immigrants. When social
workers are used as enforcers
of exclusionary government
policies to the extent of “turning
in” violators, valid questions
may be raised about the extent
a social worker may meet both
legal and ethical obligations.
This Legal Issue of the Month
article reviews recent legal policy
as enacted by U.S. Congress,
the state of Arizona and related
interpretations of the law
regarding immigrants’
eligibility for public benefits,
documentation and reporting
requirements.

Anyone who has watched the
A&E channel show
“Intervention” has seen what
addiction does to the individual
and to the family. The show
mostly focuses on the person
with the addiction, but what
happens with the family in the
process of addiction? Family
members can develop patterns
of functioning that actually
support addictive behaviors.
On “Intervention,” families
have the opportunity to see
how their decisions and
behaviors reinforce the
addiction itself. Most people
struggle to understand that they
are contributing to the system
because the obvious problem is
the addiction, right? If the
person could stop using, then
everyone else would be okay.
Unfortunately, the situation is
more complicated than merely
stopping the addictive use of
substances—that is the tip of the
iceberg. Family work is
credited as one of the major
contributing factors to recovery.
How does family work influence
the person with the addiction?

What is self-esteem? This
seemingly elusive term is often
bandied about by professionals
and laymen alike. “I have no
self-esteem,” “You need to build
your self-esteem,” and “My selfesteem took a hit” have become
common phrases. Building selfesteem has, in many ways,
become the mantra of modern
society. It is spoken of in
schools and among mental
health and other professionals.
Parents of young (and often
older) children worry about
their kids’ self-esteem. But what
do people mean when they
speak of self-esteem?

THE MENTAL &
BEHAVIORAL
HEALTH Needs
of Our Military
and Returning
Veterans: An Important
Role for Social Work

With an increasing number of
veterans returning from repeated
deployments in the long wars
fought in Iraq and Afghanistan,
the mental health service needs
for this population is
skyrocketing. According to the
Department of Veterans (2010),
an estimated 2.1 million military
service members have served in
Operation Enduring Freedom
(OEF), Operation Iraqi Freedom
(OIF), and Operation New
Dawn (OND). As of March
2012, nearly 1.4 million of
these veterans were already
eligible for Veterans
Administration (VA) services,
with more than half of those
veterans reporting possible
mental health problems
(Department of Veterans,
2010). The families of both
active military members and
returning veterans are also
facing growing mental and
behavioral health needs, and
are often the catalysts for
seeking help.

CHILD FATALITIES:
An Overview of Recent
Epidemiological Data from California

When a child dies following an
allegation of maltreatment to
Child Protective Services (CPS),
public outcries are quick and
severe: the system tasked with
responding to child abuse and
neglect was informed a child
was at risk and yet failed to
intervene in a manner that kept
him or her safe. In an effort to
learn from these and other tragic
cases, Child Death Review Teams
(CDRTs) across the United
States compile data to identify
child death patterns and clusters,
examine possibly flawed
decisions made by CPS and
other systems, and summarize
the characteristics of fatally
injured children in order to take
actionable steps toward
improving child safety and
reducing child deaths (Douglas
& Cunningham, 2008).
Currently, 49 states and the
District of Columbia report
teams in place to review child
maltreatment fatalities; several
states have now moved to
investigate all causes of child
death (National Center for
Child Death Review, 2011).
Yet—absent a broader
context—such scrutiny of
individual decisions made in
isolated fatality cases offers
limited practice and policy
insights. In the case of deaths
following CPS contact, looking
only at those children who have
already died fails to inform our
understanding of how the
experiences and characteristics
of deceased children fit within
the broader population of those
who were similarly reported to
CPS—but did not die. Nor does
it allow for these deceased
children to be understood
within the population of
demographically similar
children who died despite
having never been reported to
CPS. The absence of an
epidemiological perspective
profoundly limits our ability to
make informed modifications to
CPS practices or policies. The
newly linked data sources from
the state of California advance
our knowledge of risk factors
for both non-fatal and fatal
child maltreatment.

CHILDREN OF
Returning
Warrior Parents:
Child Abuse and Neglect
Challenges of the Military and
Veteran Family Systems

It has been more than a
decade—military operations in
Iraq have finally ceased, and
there appears to be an end in
sight in terms of operational
forces in Afghanistan. More
than two million military
members have been deployed
to these conflicts. There is in
excess of two million children
with one or both parents
employed by the military (Lester
et al., 2011). Nearly one million
of these children have had a
parent deployed to a war zone,
and more than 250,000 have
had both parents simultaneously
serving in these hostile areas
(Park, 2011). Deployment of a
parent or parents to a war
zone—commonly called a
“catastrophic” stressor for
military families—greatly
enhances the risks for a range
of psychosocial problems for
military children; a parent’s
post-traumatic stress disorder
(PTSD) symptoms could manifest
as child abuse and neglect.
This is especially true in the
fast-paced, longer, and more
frequent deployments, which
are linked to higher rates of
distress, depression, and
anxiety in both the child and
the at-home caregivers (Gewirtz
et al., 2011). The focus of this
article is to explore how these
recent wars affect the children
of military families. For
instance, how do deployed
family members returning with
PTSD affect the welfare of
children in military families?
How do these stressors affect
the at-home caregiver? And
finally, how can social workers
and other community providers
address these child welfare
issues within their communities?

Do social workers find joy in
their work? If so, how? As three
curious professors of social work,
we set out to investigate these
questions. Our curiosity was
sparked by our interest in
positive psychology (e.g.,
Peterson, 2006; Seligman &
Csikszentmihalyi, 2000) and
appreciative inquiry (AI; e.g.,
Cooperrider & Whitney, 2005),
newly emerging practice fields in
psychology and organizational
development, respectively. In
contrast to psychology’s
traditional emphasis on
pathology, positive psychology
is concerned with individual,
organizational, community, and
societal experiences that relate
to health and well-being,
contentment, satisfaction, flow,
happiness, hope, and optimism.
This perspective focuses on the
study of what makes life worth
living, how individuals make
meaning and purpose out of
their lives, and how institutions,
such as workplaces, foster
satisfaction among its members.
AI focuses on a search for the
best in people and on what
gives life to human systems.
Simply put, AI purports that
what we as humans focus on
and pay attention to is what
expands in our lives. In other
words, focus on what is going
well and that is what grows in
us. Focus on pathology and
problems, and these negatives
will multiply in our lives.

Lisa Gardner, a 45-year-old
occupational therapist at a large
medical center, notices she is
having difficulty hearing in one
ear. She decides to obtain a
hearing evaluation and urges
her 80-year-old father, Joe—
who has lived with hearing loss
for decades—to join her. Lisa
takes public transportation
from her workplace to the
audiologist’s office, at a cost of
$2.50 each way. Because the
appointment is in the middle of
her workday, she is unable to
transport her father, who pays
$50 for round-trip wheelchairaccessible transportation and
another $75 for a home health
aide to escort him to and from
the appointment. Lisa has a
$25 copayment for the office
visit; Joe, on the other hand,
pays the entire $500 diagnostic
testing fee because Medicare
does not cover hearing
evaluations and he does not
have secondary insurance. The
audiologist evaluates Lisa and
Joe and recommends hearing
aids for both patients. Because
Lisa’s hearing loss is not severe,
her hearing aid costs only
$750. Knowing that many
private insurance plans do not
cover hearing aids, she is
pleasantly surprised to learn
that her employer-based plan
will pay $500 of the cost. Her
father, however, has profound
hearing loss in both ears; a pair
of hearing aids costs $5,000,
none of which is covered by
Medicare. Lisa decides to order
her hearing aid as soon as
possible and encourages her
father to do the same, offering
to help negotiate a payment
plan with the audiologist. Joe
expresses reluctance because
his retirement savings are
quickly depleting, and he
doesn’t know how he will
manage when Social Security
becomes his sole income. When
his daughter urges him to
reconsider, reminding him how
much trouble he’s had hearing
his doctors lately, Joe responds
that he’s considering skipping
his upcoming appointments;
he’s still paying bills from two
recent hospitalizations and he
doesn’t really understand how
his doctors are helping him
anyway. In an effort to avoid
the Medicare Part D “doughnut
hole,” Joe adds that he’s begun
taking his antidepressant every
other day. “It doesn’t seem to
make a difference—I feel the
same as I did when I took it
every day,” he concludes. Lisa
is distressed by her father’s
attitude toward his health; even
so, she understands his
viewpoint and worries her own
financial situation may be even
worse when she is 80—if not
years before that.

WORKING WITH MALTREATED
CHILDREN While Still Keeping
Our Sense of Hope

One of the core values of social
work is that we must always
strive to instill hope in our
clients who seek help during
very difficult and challenging
times in their lives (Kirst-Ashman
& Hull, 2012). Our complicated
society often underestimates the
importance and power of hope.
People lead busy lives and
seldom take the few minutes
necessary to truly listen to
someone else’s worries or
concerns. Too often individuals
don’t follow up with others who
need someone to talk to,
problem solve, or establish
bond. Our society doesn’t
always encourage the child who
so desperately reaches out to us
for some validation. We miss
opportunities to spend time with
people who are in physical or
emotional pain. Sometimes, we
feel so overburdened by our
own responsibilities and
challenges, reaching out to
others and providing a sense of
encouragement and hope just
seem impossible. Despite how
complex life can be for everyone,
every so often a community
crisis or natural disaster forces
us to stop our busy lives long
enough to reflect and help those
who suffer from hopelessness
(Glass et al., 2009).

My story is not unique. Rather,
I am an exemplar of the baby
boomers, members of that
historic generation born
between the years 1946 and
1964. This generation, my
generation, almost 80 million
strong, consists mostly of the
children of “the greatest
generation” (Brokaw, 2004).
While the media often divides
the generations by wars,
values, and ages, there are also
cultural differences that result
from sanctioned structural and
cultural divides based upon
race and gender. Thus, African
American baby boomers are
uniquely influenced by the hope
for social justice that was
passed on by generations
going back to the year 1619,
when African Americans were
first captured and enslaved.

THE ROLE OF SCHOOL SOCIAL
WORKERS in Restoring Hope
for High School Graduation

In public school districts with
minority students from all ethnic
and racial backgrounds, the
dropout rate for the African
American male subgroup
appears highest. In today’s
society, completing high school
is one of the main requirements
for getting even a low-wage
job, and earning a high school
diploma or GED is the minimum
requirement for accessing
postsecondary education.

The relationship between
forgiveness and psychological,
physical, and social health and
well-being went without much
scholarly attention until around
the 1990s; however, since the
turn of the millennium,
numerous studies and booklength compendia of studies
have appeared. Researchers
and teachers—such as Robert
D. Enright, Fred Luskin, Dick
Tibbits, and others—have
elaborated on the theory and
practice of forgiveness, and
have marshaled studies on the
benefits of forgiveness; they
have written books that
combine reviews of research,
definitions and clarifications,
“how-to” pointers, and—in the
volumes devoted more to selfhelp—gentle pleadings. This
article is an attempt to
summarize the new interest in
and energy about the topic of
forgiveness, and to try to create
a model for understanding that
guides possible utilization.

WHY HUMAN RIGHTS
EDUCATION?
When discussing globalization,
it would seem natural to parlay
it into social work education.
Human rights issues strike at the
very core of social work values
and have been addressed in
social work in the United States
for more than 50 years. Social
exclusion, racial and religious
intolerance, gender inequality/
violence, and the rights of
women, children, refugees,
older people, and the lesbian,
gay, bisexual, and transgender
(LGBT) community are social
justice issues that have long
concerned social workers. With
the notion of the person-inenvironment in mind, social
workers should be aware of the
effects of human rights violations
on the growth and development
of the individual as well as
society in general. Whether in
a micro- or macro-setting, social
work education must confront
these issues not only on a local
but also on a global scale.

Many professionals and
citizens view the war on
drugs as a marketplace
problem that can be
controlled by manipulating
various aspects of the market,
such as the supply, demand,
and potential demand. Simply
put, this approach posits that if
one wants to minimize the use
of licit or illicit substances, then
all one needs to do is decrease
the supply and the demand will
“dry up.” Or, conversely,
decrease the desire for drugs,
and the suppliers will be put
out of business. Theoretically,
this approach sounds like a
solid one; practically, it will not
work effectively.
There are various reasons why
the “market” approach will not
work well. First, as is typical in
these approaches, they tend to
leave out an important
ingredient: how individuals
manage their own pain and
suffering. As a client of mine
recently suggested, “As long
as there is pain in the world,
there will be drug abuse.” Pain
comes in many forms: physical,
emotional, psychological, social,
and financial; hence, people
typically attempt to avoid or
minimize pain. If the pain is
removed, or if people learn to
cope with their pain(s) in more
healthy ways, then the use and
abuse of substances is
minimized.

RESTORING HOPE
in Families with a Suicidal Youth:
Attachment-Based Family Therapy

On the evening of March 9,
2012, Eden Wormer, an
eighth-grade student in
Vancouver, Washington, gave
her father a hug and a kiss and
said, “I love you daddy,
goodnight” (Sinmaz, 2012).
The next morning, she was
found dead in her room; she
had hanged herself. Somewhere
between the hug and kiss, and
the morning light, Eden decided
the best way to solve her
problems—being victimized
by bullies, feeling ostracized
and misunderstood—was to
kill herself.
The tragedy of Eden Wormer’s
suicide is compounded by a
grim statistic: by the end of
2012, more than 1,800 young
adults in the United States will
die by suicide, making it the
third leading cause of death
among youth ages 5 to 19. For
each child who commits
suicide, there are hundreds of
thousands more who are at
risk. In 2011, 15.8 percent of
high school students reported
seriously considering suicide,
12.8 percent reported making
a suicide plan, 7.8 percent
attempted suicide, and 2.4
percent reported receiving
treatment from a doctor or
nurse as a result of their suicide
attempt (Eaton et al., 2012).
One of the most disturbing
aspects of these statistics is that
they represent the first increase
in youth suicidal ideation,
planning, and attempts since
1995, reversing a 15-year
downward trend. Although
social workers are expected to
provide crisis intervention
services, including suicide
assessment and intervention
(CSWE, 2009), they receive
very little training in the
treatment and management of
suicidal behaviors (Feldman &
Freedenthal, 2006). Therefore,
this article will provide a brief
overview of an empirically
supported approach to working
with suicidal youth and their
families—attachment-based
family therapy (ABFT) (Diamond
et al., 2010).

SOCIAL WORK STRATEGIES:
Implementing Hope
in Adjudicated
Youths and Their
Families

SENSE OF HOPELESSNESS
In working with adjudicated
youth within the criminal justice
system, you often find—in
addition to all of the
disadvantages or challenges
they may face in integrating
back into society—one of the
biggest barriers is their selfinflicted sense of hopelessness.
Among the adolescents who
are most involved in the
juvenile justice system is an
overrepresentation of youths
who are minorities and/or who
are from lower-income families
or impoverished communities.
As cited by Peters (2011),
“the correctional system affects
individuals and communities at
the heart of social work’s effort:
people who are poor and
people of color” (p. 355).

I am smiling. While writing this
article, I kept discovering
examples of how social work
and the court are such intrinsic
parts of me. My life began as
an adoptee by a social worker
who had served in adoption/
foster care. I’m told I toddled
around announcing and smiling
proudly, “I ’dopted.” When I
was old enough to pronounce
the word, and ask some
questions, she told me about
the long waiting period to
finalize an adoption at that
time: an entire year in legal
limbo. So, from an early age I
had a deep appreciation for
the way the court related to
family life. My career interest in
the relationship between the
two fields of practice began in
the mid-1980s. As a secondgeneration social worker, I had
heard from my mother
numerous examples supporting
the joining of the two areas in
practice. While getting my
BSW with a minor in justice
studies, I decided to pursue
dual advanced degrees in law
and social work. I had delved
into broadening my knowledge
of how the two professions
combined, and I became a fast
fan of the term “therapeutic
jurisprudence.” My
undergraduate internships
further confirmed the link
between social work and the
courts. I smiled and asked the
following question after
graduation: What kind of work
experience would be the best
way to launch my career? My
mother suggested I work in the
child welfare area because a
metropolitan New York social
service agency would allow me
to work closely with attorneys
representing mutual clients.

When we think of court
processes, the primary themes
that spring to mind tend to be
negative. We think of courts as
adversarial, costly, timeconsuming, disempowering,
and focused on the past. Yet
with psychiatrists, psychologists,
and other mental health
professionals. Further, the
NASW and other social work
organizations have submitted
influential amicus briefs in
cases concerning same-sex
marriage, adoption, and other
matters. Since the 1996 case of
Jaffee v. Redmond, the United
States Supreme Court has
recognized the importance of
confidentiality in clinical social
worker–client relationships,
declaring that privilege exists,
and that licensed clinical social
workers cannot be compelled to
testify without permission of the
client. Positive judicial decisions
have continued into the current
Acceptance of social workers
as expert witnesses has been
reinforced by the growth of
forensic social work associations
and journals. Social workers
have become resilient through
education and training to
survive and thrive in court
procedures. Many schools of
social work provide courses social work and the law,
criminal justice, and child
welfare. Some social work
programs offer joint social
work/law degrees. Continuing
education courses provide
social workers with knowledge
and strategies to deal more

There is controversy in the field
of social work about describing
disordered eating as an
“addiction.” Although addiction
to certain foods is not a
recognized criteria in respect to
eating disorders within the
DSM-IV, there are interesting
parallels between the eating
patterns of some individuals
and the DSM-IV criteria for
psychoactive substance
dependence: (a) the substance
is often consumed in larger
amounts or over a longer
period of time than the
individual intended; (b) the
individual continues to use the
substance despite persistent or
recurrent social, psychological,
or physical problems caused or
exacerbated by the use of the
substance; (c) withdrawal
symptoms occur; and (d) the
substance is often taken to
relieve or avoid withdrawal
symptoms. Regardless of the
current debate on the addictive
quality of refined foods, some
practitioners advocate plans
that address refined foods. For
example, the Kay Sheppard
recovery food plan (Sheppard,
n.d.) is a comprehensive guide
for persons with any kind of
eating disorders and provides
details of structured food plans,
a list of trigger foods to avoid,
portion sizes, and advice on
how to implement the plan. Its
goals are: (a) eliminate
addictive substances; (b)
balance proteins and
carbohydrates; (c) manage
volume; (d) provide good
nutrition; and (e) distribute
nutrients throughout the day.

There is controversy in the field
of social work about describing
disordered eating as an
“addiction.” Although addiction
to certain foods is not a
recognized criteria in respect to
eating disorders within the
DSM-IV, there are interesting
parallels between the eating
patterns of some individuals
and the DSM-IV criteria for
psychoactive substance
dependence: (a) the substance
is often consumed in larger
amounts or over a longer
period of time than the
individual intended; (b) the
individual continues to use the
substance despite persistent or
recurrent social, psychological,
or physical problems caused or
exacerbated by the use of the
substance; (c) withdrawal
symptoms occur; and (d) the
substance is often taken to
relieve or avoid withdrawal
symptoms. Regardless of the
current debate on the addictive
quality of refined foods, some
practitioners advocate plans
that address refined foods. For
example, the Kay Sheppard
recovery food plan (Sheppard,
n.d.) is a comprehensive guide
for persons with any kind of
eating disorders and provides
details of structured food plans,
a list of trigger foods to avoid,
portion sizes, and advice on
how to implement the plan. Its
goals are: (a) eliminate
addictive substances; (b)
balance proteins and
carbohydrates; (c) manage
volume; (d) provide good
nutrition; and (e) distribute
nutrients throughout the day.
The Department of Social Work
and Communication Sciences
and Disorders College of
Education & Human Services at
Lakewood University in Virginia
conducted an online survey
designed to investigate
problems that individuals have
with their consumption of food
and drink. The type of measure
used was self-completed,
multiple choice and fill-in-the
blank. There were a total of
300 email invitations. The
sample consisted primarily of
women. There were a total of
150 responses received. The
response rate was 50 percent.
The survey was used to assess
the efficacy of using a
structured meal approach as
part of a treatment for eating
disorders. Respondents (n=356)
were female, predominantly
white, and typically between
the ages of 41 and 60. Of
them, 38.5 percent reported
that they had been formally
diagnosed with an eating
disorder. When asked whether
they identify themselves as food
addicts, 96.9 percent replied
affirmatively. More than half of
the total respondents indicated
that they were currently
implementing the plan always/
most of the time with 80.3
percent indicating it was a lot
of help/completely helpful.
Therefore, a structured meal
approach may be beneficial in
individuals with eating disorders.
In addition, 39 percent (n=139)
reported an allergy to sugar,
flour, and wheat. This allergy
often causes a craving that
requires more food, resulting in
bingeing. Of the respondents,
80.6 percent (n=287) reported
attending some kind of support
group for their addiction to
sugar, flour, and wheat. The
most common was a 12-step
program (82.2 percent) (Table
3). In terms of the type of
meeting involved, 151
respondents (52.6 percent)
reported a face-to-face meeting,
whereas online and telephone
meetings constituted only 4.5
percent and 2.1 percent,
respectively. However, 40.8
percent of respondents
indicated that they used a
combination of these three
types of meetings. In terms of
specific organizations reported,
Kay Sheppard’s own
organization (the Loop) was the
most common (26.5 percent),
followed by Overeaters
Anonymous (11.6 percent),
and Food Addicts in Recovery
(7.3 percent) (Table 4).
However, 34.9 percent of
respondents (n=96) reported
using multiple organizations.

A CALL TO ACTION:
Ten Years of War and the Effects
on America’s Military Children

America has been at war for
10 years. During that time,
approximately two million
service members have
deployed to Iraq and
Afghanistan in support of
Operation Iraqi Freedom and
Operation Enduring Freedom
(Tanielian & Jaycox, 2008).
There is only preliminary
evidence of the effects of
deployments on children who
have had a parent deployed
since 2001 (Flake et al.,
2009).
The Army refers to the
deployment cycle as the Army
Force Generation Cycle
(ARFORGEN). It is the cycle
that an Army unit follows from
train-up to deployment to the
return of the unit. This cycle
takes a toll on families, which is
referred to as the “Emotional
Cycle of Deployment.” In
2006, Dr Jennifer Morse
described the cycle as having
seven stages:

Each year the United
States reports that
adolescent pregnancies
number over one million.
More than 500,000
births are recorded from these
pregnancies, which means that
an average of 55 teens give
birth every hour (U.S.
Department of Health and
Human Services, 2002).
Estimates of the number of teen
fathers are more difficult, but
close to half of the babies born
to teen mothers also had fathers
who were teens. With these
statistics, the United States has
one of the highest teen
pregnancy rates in the
industrialized world. Yet, how
do educational programs in our
country meet the needs of these
teen parents?
Teenage mothers are at great
risk in society. Many are
economically disadvantaged,
and a large proportion drop
out without completing high
school (Hofferth, Reid, & Mott,
2001). With few employable
skills, they all too often end up
in low-paying jobs and/or
receive government benefits over
a substantial period. Having a
child before the age of 20
reduces the amount of education
attained (high school and
college) by an average of three
years (Kirby, Coyle, & Gould,
2001). Early child bearers are
less likely to graduate from high
school: 41% of mothers who
have children before age 18
complete high school, compared
with 61% of mothers who delay
childbirth until age 20 or 21
(Casserly, Carpenter, & Halycon,
2001). In addition, many lack
effective parenting skills, which
results in their children beginning
school behind their peers. This
can lead to intergenerational
poverty when disadvantage
crosses generations.

The population of
children presenting with
signs/symptoms of
trauma is increasing at an
alarming rate. The American
Psychological Association
(2008) defines traumatic events
as inclusive of sexual and/or
physical abuse, domestic,
community, and school
violence, among numerous
other forms of trauma. The
traditional treatment options,
although often successful, are
not meeting the needs of many
children with trauma. In
response, therapists have had
to explore other therapeutic
interventions to connect with
this difficult-to-reach population.

What exactly are we talking
about when we say the word,
“hope?” How do we put it into
operation and what elements
are we describing? Is what I
mean when I use the word
hope the same as what you
mean by the word hope? Do
we learn to believe in hope
from our parents or someone
important in our lives? What
would our world be like without
hope? Can it be lost to some
people? How do people lose
hope? If hope is lost, how is it
recovered? What does it take,
exactly, to have hope? Can
having hope be taught? If so,
what would that look like?
C.R. Snyder, the renowned
University of Kansas psychologist
describes it this way, “Hope is
believing you have both the
will/agency and the way/
pathway to accomplish your
goals, whatever they may be.
Hope is the sum of perceived
capabilities to produce routes
to desired goals, along with the
perceived motivation to use
those routes. So hope is a kind
of glue that holds together the
rest of the human condition as
well as the energy that moves
us ahead (Snyder, 2000).”

Hearing voices, or voicehearing, is commonly identified
as a form of auditory
hallucination. Auditory
hallucinations are a symptom
frequently associated with a
diagnosis of schizophrenia, so
much so that auditory
hallucinations have been called
a “hallmark symptom” of
schizophrenia (Wible et al.,
2009). Over the past thirty
years, however, a grass-roots
movement has been growing
among voice-hearers in Europe,
the United Kingdom, and
elsewhere around the globe.
The movement has now crossed
the Atlantic, and identifies
hearing voices as part of the
human experience, rather than
as a symptom of pathology
(Klafki, 2007; Romme &
Escher, 2007). One of its
forums, Intervoice: The
International Community for
Hearing Voices (Romme &
Escher, 2007), has an online
presence (www.intervoice
online.org) that can be a source
of hope and inspiration for
many people experiencing
voice-hearing. Intervoice is not
alone – the Hearing Voices
Network is an example of
another such organization.
What sparked this apparent
shift in thinking about voicehearing? Is this merely wishful
thinking, or is there a basis for
hope in this movement? And
finally, what can this mean for
us, as social workers?

The “cloud” is a term that is now used to
describe a series of Web-based services that
“reside” on the Internet as opposed to a local
computer. Today’s technologies are moving to the cloud in what is also known as a “Software
as a Service” (SaaS) model.

Movement toward state automated child
welfare information systems (SACWIS)
began in 1993 when the federal government
passed legislation (Public Law 103-66)
providing for a 75 percent match to state funds
spent on the development, implementation,
and operation of a SACWIS. The main goal of
this incentive was to provide a common
collection mechanism for the Adoption and
Foster Care Analysis and Reporting System
(AFCARS) and the National Child Abuse and
Neglect Data System. Secondary goals of this system were to automate case management
functions and to provide an avenue through which child welfare systems could effectively
communicate with state programs administering Aid to Families with Dependent
Children/Temporary Aid to Needy Families, Medicaid, and child support.

I hear you. I have some good news
for you, too. You see that laptop,
smart phone, or tablet computer right
in front of you? Just as easily as you
can access your e-mail or FaceBook,
you can become an evidence-based
social worker. The Internet is a game
changer that can provide you with
high-quality information about
practice and teach you how to use
that information to make decisions
about your practice.

Child welfare is considered one
of the most stressful social work
jobs in the country. In New York
City, which receives more than
64,000 reports of suspected
abuse or neglect annually
(NYCACS, 2011), it is doubly
so. Protective specialists are
called on to assess the safety
of children, initiate essential
services, and facilitate the
participation of troubled
families in viable permanency
plans; at the same time, these
workers have no control over
the number or severity of cases
assigned to them. As a result,
more caseworkers feel stressed
and overworked. Their
assessment can mean the
difference between life and
death for a child (Rakoczy,
2011).

Those of us in private practice have to make special commitments to ourselves toprotect our energy. Some social workers employed by agencies and other resources have such programs builtin, such as retreats and staff development opportunities, and in some private settings, perhaps agym, yoga lessons,and even apool for exercise. In private practice, however, it is entirely up to us to carve out these opportunities for ourselves, in atough economy, and with many demands to balance.

Social workers have important contributions to make in working with people coping with geneticconditions.The rapid pace of medical advances and increased treatment options for phenylketonuria(PKU), for example, have challenged the clinical interdisciplinary team to offer more comprehensiveassessments and further program development. In addition to the metabolic abnormality, manypsychosocial concernsare visible in this patient population and have often required further evaluationand referral to a mental health specialist.Unfortunately, comprehensive mental health screeningstargeting emotional and behavioral concerns are not routinely implemented during outpatientappointments within our metabolic genetic population. In this report we illustrate the integral role thatsocial work provided in the introduction and implementation of mental health screening questionnaires inthe PKU Clinicat Children’s Memorial Hospital.

BOOK REVIEW:
Skinny Revisited: Rethinking Anorexia Nervosa
and Its Treatment

Clinical social workers interested
in learning more about treating
anorexia nervosa will find this
book useful. It reflects an
applied approach to anorexia
nervosa utilizing the social work
profession’s general perspective
of person in environment.
Written by seasoned clinical
social worker Dr. Maria Baratta,
the book views the disease and
its treatment through an
additional lens, the feminist
socio behavioral perspective.

The bill, SB 432: An Act
Concerning the Provision of
Social Work Services in School
Districts, would have required
all local school districts in
Connecticut that employed
school social workers to contract
with a community-based
nonprofit agency for school
social workers. The stated
purpose of the bill was to reduce
the cost to school boards for
school social work services. The
bill’s sponsor was a Republican
state senator on the Education
Committee.

I decided to write this article,
because I want other social
workers and social work students
to benefit from what I learned
the hard way about looking for
and working in a job after
getting my master’s of social
work (MSW). I will discuss many
of the things that I wish someone
had told me when I graduated
and before I started my first job.
Learn from my experiences.

LIVING OVERSEAS IS ALWAYS
an Adventure:Part II of The Role of Mental Health and
Effective Coping Strategies in Expatriates

In —, “ Part I of The Role of
Mental Health and Effective
Coping Strategies in
Expatriates,” areas of stress for
expatriates include a reduced
sense of self, local pressures,
relationship strain, and isolation.
The notion of the reduced self
was directly related to social
support, positive recognition,
and valuing. The daily pressure
of dealing with a foreign culture
and individual health and safety
is a major concern. Authors
Hagan and Hill will discuss in
the second part of the article on
expatriate stress a more personal
account of the challenges faced
by them as expatriates.

IDENTIFYING, LOCATING,
CONTACTING, AND ENGAGING
Nonresident Fathers of Children
in Foster Care(Part 1 of a 2 Part Series)

In the past, fathers have been largely absent from the research and writings on child welfare. In
1990, two researchers
reviewed five major journals
where studies and theoretical
writings related to child abuse
and neglect were commonly
published. While fathers are
still not as visible as mothers in
the literature, they are no longer
“ghosts” or “afterthoughts” as
they were once described
(Brown, et al., 2009; Lee, et
al., 2009). For example, a
recent study, building on the
work of Grief and Bailey, found
62 articles in six journals
between the years 2004-2008
that dealt explicitly with fathers
in child welfare. While this was
a significant gain, the authors of this study concluded that
“there continues
to be…a significant lack
of research including fathers
relative to mothers in
family-related
research” (Shapiro and
Krysik, 2010).

WHEN THE FIELD
IS IN CRISIS: The
Impact of World Events
on Field Supervision
and Student Learning

The Council on Social
Work Education deems
field education to be the
signature pedagogy of social
work (Homonoff, 2008). As the
capstone of social work
education, field experience
represents the culmination of a
student’s learning where theory,
practice, policy, and research
converge in real-world
application. Field supervisors
and faculty field instructors
attempt to provide students with
the most current information
available in the profession
(NASW, 2008). They often
struggle to prepare students to
navigate between the world of
best practice and realistic
practice. Ideally, the tenets of
the two remain closely aligned.
Current world events, however,
can create a schism between
the two worlds.

In “The Urgency of Social
Worker Safety,” National
Association of Social Workers
(NASW) past President James J.
Kelly, PhD, LCSW, emphasizes
the following:
In the past few years alone,
we have witnessed the fatal
stabbing of a clinical social
worker in Boston, the deadly
beating of a social service
aide in Kentucky, the sexual
assault and murder of a social
worker in West Virginia, the
shooting of a clinical social
worker and Navy commander
at a mental health clinic in
Baghdad, and the brutal
slaying of social worker Teri
Zenner in Kansas. These are
only a few of the murders of
our colleagues, which, along
with numerous assaults and
threats of violence, paint a
troubling picture for the
profession. (Kelly, 2010)

Kidney failure occurs when the
kidneys’ normal functioning
slows or the kidneys stop
filtering waste properly. The
United States Renal Data System
(USRDS) 2009 annual data
report indicated that in 2007
there were more than 111,000
people in the United States being
treated for kidney failure, also
called end stage renal disease,
or ESRD (p. 7). Of these, 1,304
(1.2%) were children under the
age of 19 (p. 7).
Kidney failure may be acute or
chronic. Causes of acute kidney
failure may be due to bacterial
infection, injury, heart failure,
poisoning, or drug overdose.
Treatment includes correcting
the problem leading to the
failure and in rare cases
requires dialysis. Chronic
kidney failure involves a
deterioration of kidney function
over time. In teens and young
children, it can result from the
acute kidney failure that fails to
improve; birth defects; chronic
kidney diseases; or chronic,
severe high blood pressure. If
diagnosed early, chronic
kidney failure can be treated.
The goal of treatment usually is
to slow the decline in kidney
function with medication, blood
pressure control, and diet.
Dialysis on a regular basis is
also a treatment alternative in
some cases, and at some point
a kidney transplant may be
required (kidshealth.org).

Despite advances in
medicine and
technology, gaps
remain between the
health status of minorities and
nonminorities in teen maternal,
newborn, and child health. The
rates of unplanned pregnancies
are higher among minority
youth, accompanied by major
risk factors that contribute to
poor pregnancy outcomes.
Some of these risk factors
include delayed, or lack of,
prenatal care, resulting in
increased risk of both low birth
weight and premature birth for
newborns. Data indicate that
nationally about 13 percent
of African American teens and
13 percent of Hispanic teens
become pregnant each year,
compared with 4 percent of
Caucasian teens. Likewise,
women living in poverty are
four times more likely to
become pregnant unintentionally
than women of greater means
(Boonstra, 2010).

The 2010 Haiti
earthquake and the
2011 Japan earthquake,
which was followed by
a tsunami and radiation leak,
must be associated with
psychological trauma as well.
In times of natural disaster,
individual health crisis, suffering,
tragedy, and loss, the most
human reaction is to ask,
“Why?” Some turn to religion or
higher power for answers, hope,
and strength. Spirituality is a
powerful human experience. A
study conducted by Jacobs
(2010) concluded that it was
very helpful for clinical social
workers and mental health
professionals to explore
spirituality and religious beliefs
in the context of the ways clients
make meaning of life
circumstances.

One of the more confusing
aspects of the diagnosis of
attention deficit disorder (ADD)
is how the concept of proper
attention is evaluated. As social
workers, we might ask ourselves
these questions: “Were multiple
measurements used?” and “Did
the information gathered tell the
whole story?” (Padgett, 2003).
This brief overview will attempt
to clarify some of the issues that
are a central component in
evaluating attention. The main
factors affecting attention span
are as follows:
• Type of attention
• Learning disabilities
• Amount of energy
• Distractibility level
• Impulsivity level
• Anxiety or obsessive thoughts

The dropout rate for
American Indian
students is the highest of
any ethnic or racial group in
the United States and is more
than twice as high as
White/non-Hispanic students
(7.6 % versus 3%, respectively)
(Stillwell, 2009). There are
many reasons American Indian
students drop out of high
school, such as school climate,
bullying, academic problems,
emotional problems, lack of
parental support, and feelings
that teachers did not care for
them and are not providing
enough assistance (Faircloth &
Tippeconnic, 2010). School
social workers can work with
school administrators to help
these students stay in school
and earn their diplomas.

If you are a geriatric social
worker with a caseload of
families with dysfunctional
issues, you may have found
yourself dealing with escalating
aging family clashes that
erupted during the holiday
season. Families with aging
members are often filled with
warring, midlife siblings. At
ritual gatherings, these brothers
and sisters often ignore their
estranged siblings. Once a
few drinks are downed or
buttons are pushed, battles
can break out, giving everyone
chronic acid indigestion and
leaving them wondering where
to turn for help.

Integrative Family and Systems Treatment (I-FAST) with Children and Adolescents with Severe Emotional and Behavioral Problems

When parents have a child with
a severe emotional and/or
behavioral problem they‘ve
been unable to resolve on their
own, they are often directed to
take the child for mental health
treatment. What has often
become standard practice for
emotionally or behaviorally
disturbed children is to label
them with serious conditions,
such as bipolar disorder, and
treat the condition primarily
with very powerful, expensive,
and often multiple medications.
On the other hand, there is
mounting evidence that many
child mental health problems
are a product of chronic and
problematic family relationship
patterns and if these patterns
can be broken, the child’s
mental health problems
dramatically improve, or are
totally resolved. There are
currently several evidencebased
approaches for treating
families with high-risk youth,
including, but not limited to,
Multisystemic Therapy,
Multidimensional Family
Therapy, Functional Family
Therapy, and Brief Strategic
Family Therapy.

Addressing the Prevalence of Emotional Abuse with College Age Female Students

My clinical concentration focuses on an invisible prevalence in family living:
the repetitive nature of strong patterns of emotional abuse within families.
I have codified five of these often-ignored patterns of emotional abuse that
are ruthless in their impact during the developmental years: rage, enmeshment,
rejection and abandonment, complete neglect, and extreme overprotection
and overindulgence (Smullens, 2010).

To provide a clearer picture of social work
salaries, the NASW Center for Workforce Studies
administered the first compensation and benefits
study of the social work profession in the fall of
2009. To broaden representation of the
profession beyond the NASW membership,
NASW partnered with five other social work
membership organizations: Association of
Oncology Social Work, National Hospice and
Palliative Care Organization, National Network
for Social Work Managers, Rural Social Work
Caucus, and Society for Social Work Leadership
in Health Care. The findings highlighted here are
based on 17,911 practicing social workers who
confirmed paid employment or self-employment
on October 1, 2009, in a social-work-related
position (NASW Center for Workforce Studies,
2010).

Introduction
It has been well established that the social work
profession is guided by our Code of Ethics
(NASW, 2008). Discussions of ethical concerns
are a regular part of the curricula at all accredited
schools of social work and a regular feature in
this newsletter. Yet ethical consideration of
organizational practice areas remains a subject
with limited coverage (Meacham, 2007). It is the
perspective of this article that professional social
workers are well positioned and obligated by the
Code to assist the organizations that employ
them to help develop organizational/agency
policy to prevent ethical lapses.

Inaugural Edition of Social Work and the Courts’ Section Connection Newsletter

Welcome to the inaugural edition of Social Work and the Courts’ SectionConnection newsletter. This edition debuts in the new electronic formatfor Specialty Practice Section newsletters in support of NASW’s Green Initiative. Included in this edition are national policy issues in criminal justice reform; a book review on conducting child custody evaluations; and information on the NASW Legal Defense Fund (LDF), a member resource we encourage you to use. LDF provides financial legal assistance and support for legal cases and issues of concern to NASW members and the social work profession, as well as offers pertinent legal resources, such as amicus curiae (friend of the court) briefs, “Legal Issue of the Month” articles, and Law Notes.

Extraordinary increases in the nation’s prison population—approximately 2.3 million people as of 2008, according to a recent Pew Foundation report—have driven a steadily growing movement to reform the criminal justice system. While the initial impetus for change came from reform advocates, the movement now has a very broad range of adherents, including law enforcement agencies and associations, national associations representing the criminal justice workforce, state departments of corrections, local governments, federal departments and agencies, and the Executive Branch and members of Congress. Given this level of support, it is clear the momentum for overhauling the criminal justice system is irreversible and long term.

The Hawaiian Islands are known
nationally and internationally as the
islands of “Aloha,” which in its
simplest translation means “love.”
The Hawaiian Islands are where
travelers around the world come
to experience some of the world’s
greatest hospitality and scenery while
experiencing an advertised dream of
never-ending bliss. However, many of
these travelers and others are unaware
of Hawaii’s epic and tumultuous
history as a sovereign independent
nation that eventually became
America’s 50th state. This article
provides an overview of the issue of
sovereignty of the native Hawaiian
people, who are also known as the
Kanaka Maoli, focusing on why their
sovereignty, or the right to govern and
determine their own future, is so
important to them and measures they
are exploring to obtain sovereignty.
The second purpose of this article is to
educate social workers about the
Kanaka Maoli to encourage them to
support and affirm this indigenous,
aboriginal people, as well as to assist
with confronting the social injustices
for all native people, including the
Kanaka Maoli...

Research on reunion in adoption typically includes the
adoptive parents in terms of their support of search and the
reunion process. Adoptive parents express concern about
how the reunion will affect their child, whether or not their
child will be accepted by the birth parent, whether they will
lose their child to the birth parent, whether they will be
judged by both the child and the birth parent, and how
they themselves will integrate the new experiences into their
lives. In 1982, Depp conducted a small study involving six
adoptive parent couples. She found that initially, adoptive
parents felt the most threatened of the three parties by
reunions but perceived the reunion experience itself as
positive. She concluded that “adoptive parents are capable
of coming to appreciate the adoptee’s need for a reunion”
(Depp, 1982, p. 118). Petta and Steed (2005) studied 21
adoptive parents who had participated in such reunions...

Clinical Interventions for Service
Members Experiencing PTSD
and Substance Abuse

Eight years of combat in Iraq and Afghanistan
have increased the visibility of the mental health
needs of returning service members and the
services that are available to them. Much of
this focus has been on service members with
post traumatic stress disorder (PTSD). However,
recent research has documented the complex
interaction between PTSD and a number of
social, demographic, and behavioral
considerations. One of the most important of
these considerations is the relationship between
alcohol abuse and PTSD. In a comprehensive
literature review, PTSD was found to be
predictive of alcohol abuse, while alcohol abuse
exacerbated PTSD symptoms (Jacobsen,
Southwick, & Kosten, 2001)...

Violence in the workplace continues to
be a critical issue in this country for a
wide range of workers who serve the
general public, including convenience
store clerks, cab drivers, teachers,
nurses, and social workers. Violence
actually happens relatively rarely, with,
of course, some exceptions. Because
the odds are usually in favor of
violence not occurring, social workers
can have a false sense of security and
not take precautions necessary to
ensuring their safety. When violence
does occur, the effects can be
devastating. Incidents of client violence
toward social workers, including quite
serious ones, are continuing to occur.
Literature confirms that client violence
toward social workers, both nationally
and internationally, does occur and
warrants action and concern...

One of the most perplexing and frustrating
situations for social workers in mental health
settings is trying to engage and help an individual
with serious mental illness who lacks insight into
his or her illness and, thus, refuses to accept
treatment. The following is one example:
Since her first episode of illness, Jamie has had
ten involuntary hospitalizations, over the course
of two years, for the treatment of schizophrenia.
During each hospitalization, Jamie’s psychiatrist
and social worker tried to help her understand
her illness and the importance of taking
medication to improve her daily functioning. Her
family participated in family psychoeducation
sessions with the social worker, but Jamie
continued to refuse medication or any form of
psychosocial treatment, stating “I am not the
problem here!” With only intermittent treatment,
Jamie’s symptoms became more chronic and
unremitting in nature, and her psychosocial
functioning significantly deteriorated. Finally, her
family turned to the courts for support and
obtained an order of conservatorship that forced
Jamie to accept outpatient treatment and
medication. Jamie was incensed at the court’s
action, and, subsequently, she borrowed money
from a friend and disappeared. The last time
Jamie’s parents heard from her, she was engaging
in prostitution to support her drug habit and
living on the streets...

Sitka by the Sea/Sheet K’Kwan lies on the Pacific coast of Baranof Island. With a population just over 8,000, all nestled like Petrushka dolls on 17 miles of road, it is almost entirely
uninhabited by humans. Baranof Island also has two smaller communities – Port Alexander (pop. 100) on the southern tip and Baranof Warm Springs (pop. 10) on the east side of the island.
In between are forest, mountains,
grizzlies, deer, and the sea with an abundance of life − much of it harvested commercially and for subsistence by locals and, most importantly, the indigenous Tlingit people who have been here 10,000 years. Upon moving here from Fairbanks (pop. 60,000) in
1988, there was only one other mental health practitioner. And this remained the case for many years before the non-profits and the private sector grew.
Accessible only by boat or plane,
continuing education in Sitka used to be a logistical nightmare. Fortunately, we can now go online to get continuing education (CE) credits.

What Do You Do When a Medical
Crisis Happens in the Private
Practitioner’s Life?

Many social workers are so engrossed in their private practice that they neglect their own health or ignore the warning signs of emerging health-related problems. Then, when a medical
crisis happens, there is often no time to prepare clients or safeguard the everyday operations of their practice. Private practice clinicians often
do not participate in regular consultation which could help identify emerging physical problems
or the development of professional grief. Instead, some practitioners continue, unaware of growing
health or mental health problems until they are mentioned by a colleague.

There are many challenges that become reality with a cancer
diagnosis. For many patients, this illness creates great levels of
anxiety and fear regarding life and one’s chance for survival.
This dynamic, in turn, sets a tone that echoes throughout the
process of treatment, side effects, and even post-treatment
survivorship....

The Harlem Children’s Zone (HCZ) has garnered the attention of a national audience. President
and CEO of HCZ Geoffrey Canada has been featured several times in the national media, including in an American Express/Take Part
Members Project campaign ad that aired during Oscar night in March 2010. He also has been interviewed on 60 Minutes and the Today Show.
As a model program, the Harlem Children’s Zone is the inspiration, the catalyst, and the template for this White House Administration’s Promise
Neighborhoods Initiative, designed to provide planning grants to 20 communities across the
United States beginning September 2010...

Evidence-Based Practice in
School Social Work:
Clarifying Concepts and
Common Confusions

Len Gibbs (2003) was one of first authors to
discuss evidence-based practice in social work.
He describes evidence-based practice as:
Placing the client’s benefits first, evidencebased
practitioners adopt a process of lifelong
learning that involves continually posing
specific questions of direct practical importance
to clients, searching objectively and efficiently
for the current best evidence relative to each
question, and taking appropriate action guided
by evidence (p. 6)...

Alternative education means many different things to many different people. Alternative education can refer to schools or programs
that provide non-traditional, new, or nonstandard educational options for students who are not presently academically successful
in comprehensive educational environments, “paying particular attention to the student’s
individual social needs and academic requirements for a high school diploma” (Smink & Reimer, 2005). Alternative education
options include continuation schools—an alternative to comprehensive high school,
primarily for students who are considered at-risk of not graduating at the normal pace due to disciplinary reasons, teen pregnancy, drug use, etc., or alternatively because they are mentally gifted and the regular high school pace is below
their level—opportunity programs, Regional Occupational Programs (ROP), and adult education options. Martens (2004) states that
alternative education settings are designed to accommodate educational, behavioral, and/or
medical needs of children and adolescents that cannot be adequately addressed in a traditional school environment. Usually these students are
offered the possibility of shorter school days and open-entry/open-exit formats through “participating in a variable credit” schema...

In the beginning when we were
learning to drive, the one message
that seemed to always follow us was: “Driving is a privilege, not a right.”
After finally passing all of the driving tests and exams, we looked forward to exploring the open roads and going wherever we pleased. License renewal
was easy, and as long as we avoided
moving violations and driving under
the influence, we never needed to
worry about losing our driving
privileges. As we grow older, the worry and concern of losing the privilege to drive rest solely on our own shoulders. That is, of course, until we hit the
“mature driving age” of 50.

For decades, the state of Florida has faced the challenges of caring for an aging population with
the highest percentage of citizens who are age 60 and older in the nation. In an effort to meet
the needs of an aging population, Florida enacted a constitutional amendment in 1988 and a state
statute in 1991 that created the Department of Elder Affairs (DOEA), which officially began
operation in 1992. DOEA works with Florida’s 11 Area Agencies on Aging (AAA) that were established, as mandated, by the federal Older
Americans Act of 1995. These 11 AAAs coordinate senior services for the state’s 67 counties by establishing an aging services
network with local government and non-profit agencies that provide direct services to elders in
Florida (Florida, DOEA, 2009b, p.9).

The Association of Family Conciliation and Courts (AFCC) defines parenting coordination as:
[A] child-focused alternative
dispute resolution process in
which a mental health or legal
professional with mediation
training and experience assists
high conflict parents to implement
their parenting plan by facilitating the resolution of their disputes in a timely manner, educating parents about children’s needs, and with prior approval of the parties and/or the court, making decisions within the scope of the court order or appointment
contract. (2005, p. 2)...

Many of us may have fond memories of returning home from school and having one of our parents greet us with a homemade snack and a warm smile, inquiring about our day, and being ready to assist us with homework or play a game. Such experiences, however, are increasingly rare due to the number of dual-income and single-parent families, extended working hours, and lengthy commutes. Children today are frequently left on their own after school to
navigate the complexities of our world, without the security
of having engaged, responsible adults available to provide
the necessary support during school transitions and
non-school times. Current economic and social conditions have further compounded the situation...

Helping a child live with a chronic illness is a constant balancing act−for the parents, the
family, and the sick child. Parents want their children to be healthy, happy, and active
participants in a multitude of nurturing activities that give them joy. But when children develop
chronic illnesses, everything that was once dependable and routine can suddenly change, often keeping them from experiencing the very
activities that once provided fun and engagement. The entire family system is also affected (Mussatto, 2006), as attention is turned toward the sick child.” Families often experience intense anxiety, helplessness, and fear. Social workers can help families cope with feelings, negotiate the
medical system, find appropriate resources, feel empowered, and enhance natural sources of
resilience and support” (Mizrahi & Davis, 2008)...

It is evident that children experience the world differently than adults. Children pass through
the same stages of grief as adults; however, they grieve and express their grief in much different ways. It is natural for children to be interested
in death as a “normal part of cognitive, social and personality development” and it is important
to understand that this development will occur whether “guided, distorted, or neglected by adults” (Kastenbaum, 2000, p. 10). It is equally
important to recognize that children are still developing cognitively, and the concept of death can be a very difficult thing for children to grasp.
Nonetheless, children tend to understand what death is and what their loss means to them, to
some degree; but frequently, they cannot withstand the pain that accompanies their level of
understanding (Ward-Wimmer & Napoli, 2000)...

Could children and adolescents truly be at greater risk of serious injury or death today, due to risky behaviors, than they were a decade ago? At first glance, the answer appears to be “No.” When we delve a bit deeper into modern culture, though, a troubling trend appears to emerge...

Sexuality is a core aspect of our being. It reflects our biology, psychology, cultural and social context, and religious and spiritual roots. Understanding the holistic nature of sexuality is important for social workers who treat or provide services for adolescents in various practice settings...

The Joint Commission, formerly
known as the Joint Commission on
Accreditation of Healthcare
Organizations, is an independent,
not-for-profit organization that
accredits health care agencies by
evaluating quality and safety
standards of care. Each health care
organization—whether it’s a general
hospital, long-term care, ambulatory care, or behavioral health care facility—is evaluated by an on-site team of health care professionals at least once every three years (“What Is the Joint Commission,” 2009). In the
United States, the Joint Commission
accredits over 16,000 organizations
(“Facts about the Joint Commission,” 2009) and works with the federal government to improve health care standards...

We need you to speak out on behalf of our nation's service men and women once more. Congressman Denny Rehberg from Montana has introduced the companion bill to S. 711, the Post Deployment Health Assessment Act of 2009. We appreciate the immense support for S. 711 and we must ensure these bills garner broad support in the House and Senate...

Paternal Resources Available in
Child in Need of Protection and
Services (CHIPS) Cases

Children are disadvantaged as grievers. They do not have the same language abilities, cognitive
understanding, and experience that adults do. Children look to adults for cues in how to grieve. They are affected by the emotions of others and learn the “rules” for grieving from observing others. Professionals have an opportunity to role model permission for a variety of feelings and help in identifying support systems...

Evidence-Based Practice and the
California Clearinghouse for Child Welfare: Great Tools for Social Workers

Corporal punishment has existed in American schools since early colonial times, but the debate about its usefulness continues today. Twenty-one states permit this practice, while 29 states and the District of Columbia banned corporal punishment and instituted nonviolent alternatives to address student comportment.

January 4, 2007 was the beginning of the newly elected, Democratic controlled Congress. With Representative Nancy Pelosi (D-CA-38) as the first woman Speaker of the House and Senator Harry Reid (DNV) as the new Majority Leader in the Senate, the 110th Congress is off to a great start. With 2006 election cycle being titled the “Year of the Woman,” this Congressional class represents a more diverse class than ever before. Below, please see the ethnic diversity breakdown of the 110th Congress:

Risk Taking Behaviors Among
Children and Adolescents:
Implications for Today and
the Future

According to government statistics, risky behaviors that contribute to the leading cause of
death and serious injury categories among children have decreased. Yet new reports of
children and adolescents engaging in risky behaviors that lead to death, serious injury, or
dismemberment are widely reported. Social workers, parents, and society in general must be proactive, empowering, and knowledgeable when
working with adolescents. So much is at stake, in terms of lives lost and the financial costs
associated with risky behaviors. But most importantly, in protecting our children, we are
safeguarding their future happiness and the future
of our country.

The long-recognized healing power of writing can also unfold in old-fashioned, paper-based
journaling or diary-keeping. However, in today’s world, social workers should not discount
blogging as an option. When the proper safeguards are in effect, online conversations can prove a powerful extension of in-person therapy for today’s seemingly wired-from-the-womb kids.

Osteoporosis is a major public health concern because of the subsequent disability, diminished quality of life, and high mortality rates for those
afflicted, according to the World
Health Organization (1999). The
perception that osteoporosis is an
older person’s disease, however, is an erroneous one. Osteoporosis does not discriminate by age, according to the National Osteoporosis Foundation (NOF, 2007). It is important that
health social workers be alert to the early onset of this debilitating disease that affects clients of all ages.

Since eating disorders are so often associated with females, men with EDs are often overlooked
(Andersen, Cohn, & Holbrook, 2000). Health care professionals do not usually think of eating
disorders occurring in men, so important diagnoses are often missed (Andersen, Cohn, &
Holbrook, 2000). Therefore, it is essential that social workers become aware that men are at risk
for eating disorders, and that they screen clients for EDs when possible. Interacting with each new client, social workers have an opportunity to save lives and stem the increasing cases of males with EDs by improving their ability to diagnose male EDs and by continuing to deepen their understanding of EDs among men and adolescent males.

A group of childhood research centers in Boston,
Chicago, New Orleans, Washington, DC, St.
Louis, MO, and Durham, NC, are now looking
at the minds of preschoolers anew (Zito et al.,
2002). In addition to finding depression, they are finding preschoolers with other psychiatric
disorders, including posttraumatic stress disorder, behavioral disorders in which children severely injure others or themselves, bipolar disorder, and various anxiety disorders.

It is not enough to seek to prevent suicide by
focusing exclusively on one risk factor, such as
depression or gender. Suicide is not easily
predicted, as it is “a consequence of complex
interactions among biological, psychological,
cultural and sociological factors” (Goldsmith,
Pellmar, Kleinman, & Bunney, 2002, p. 26).
While suicide prevention is often thought of
under the purview of mental health, numerous
reports and studies have highlighted the need for
a multifaceted approach.

This journal club model is an example of a group
structure that can be used by other social work
administrators seeking continuing education and
learning, desiring to strengthen their social work values, and wishing to be involved in a peer
support group.

The news coverage of hurricanes over the past year has brought needed attention to the issue of emergency care and protection for older adults during and after a disaster. Older people who survive a disaster may emerge with additional frailties or may feel even more vulnerable. In such cases, it is important
that social workers have a practical framework for addressing ethically sensitive issues that may arise while caring for older people in a post-disaster environment.

New Orleans, along with other cities in
Louisiana, Alabama, and Mississippi, is on
the long road to recovery. Recognizing that
the damage was not only physical but also
emotional, NASW and Louisiana State University
partnered with the U.S. Department of Veterans Affairs’ National Center on Post-Traumatic Stress Disorder to sponsor a Day of Understanding and Healing for Mental Health Professionals on December 2, 2005. Numerous OCS staff attended. The most important lesson to be learned is that when states like Louisiana make children’s needs a priority, there can be positive stories even in times of a disaster.

Sexuality is a core aspect of our being. It
reflects our biology, psychology, cultural and
social context, and religious and spiritual
roots. Understanding the holistic nature of
sexuality is important for social workers who
treat or provide services for adolescents in
various practice settings. Sexuality can be expressed in many ways, not just through genital behavior. For example, we express sexuality through body image, gender presentation, and social roles, and through the nongenital expression of affection, love, and intimacy. Learning about intimacy and relationships and understanding their sexuality are important developmental tasks for adolescents.

Hurricane Katrina hit the Gulf Coast with devastating effects on August 29, 2005. Hurricane Rita followed a similar path through
the region on September 24, and Hurricane Wilma struck the southern United States on
October 24. After each of these hurricanes, social workers with the Department of Veterans
Affairs (VA) assisted survivors in several locations, including Gulfport, Mississippi,
Washington, DC, Houston, and Atlanta.

The social work department is one of the key providers of health care services in the VHA.
Social work activities, in fact, go beyond clinical services and include an increasing emphasis on
research initiatives and the training of university
social work students. During the 2004–2005 school year, the VHA had 600 social work interns
engaged in an array of clinical services and programs.

What is a clinical trial, you ask? A clinical trial is an organized study of an experimental or unproven drug to determine the drug’s safety and
effi cacy. In other words, it is a research study to answer specifi c questions about a medication or a new way of using a known treatment. Clinical
trials, which are often funded by the government, can take place in a variety of locations, such as hospitals, universities, doctors’ offi ces, or community clinics. Participants of clinical trials
are seen regularly during the trial by staff, who monitor their health and determine the safety and effectiveness of the treatment. Increasingly, social
workers are included on the multidisciplinary health care and research teams that design, implement, and evaluate clinical trials.

The social work department is one of the key
providers of health care services in the VHA. Social work activities, in fact, go beyond clinical services and include an increasing emphasis on research initiatives and the training of university social work students.

Social workers also made significant contributions in specialized practice areas such as nephrology, hematology/oncology, and pediatrics. Increasingly, the fields of palliative care and pain management are opportunities for social work presence and
visibility. For the fi rst time, a textbook on pain management will have a chapter on the
role of social work. Internet listservs have created venues for specialized clinicians to network, advocate, and organize in a manner that was impossible in years past. In many ways we are poised to reassert and
invigorate our presence and expertise in this rich, varied, and expanding field of health
care social work.

Diversity in Canada: Implications
for Cross-Cultural Social Work
Practices

This article is not intended to tackle the issue of fi nancial diffi culties faced by families of these patients, which is a truly complicated topic that warrants advocacy for nothing less than policy change in our health care system.
Instead, what is attempted here is a presentation of the hazards and pitfalls
that this clinician’s families have encountered
while struggling to live with the illness as it bounces their loved one along today’s continuum of care. A few suggestions are provided, with an invitation to respond.

Cross-cultural training initiatives in aging between social work practitioners in industrialized and developing countries are important to further the awareness of aging in Africa. Furthermore, such training is important
to promote or assist in developing services
for older adults, to conduct education and
training programs, and to cooperate with
African governments and other organizations
in policymaking, services, and research
(AGHE, 2003; Andrews, 2003; McGadney-
Douglass, 2002).

Students’ Corner: Social Work Interventions With Gay, Lesbian, Bisexual, and Transgender Youth: the Need for Intervention

...the Bureau of Labor Statistics
(BLS) indicates job opportunities in the substance abuse treatment arena will grow rapidly between 2002 and 2012, particularly for the social work profession
(BLS, 2004). Data from the third survey of the NASW Practice Research Network (PRN) describe current activities
that social workers are involved with in the substance abuse treatment and prevention field, as well as document the need for increased professional development
in this area.

Once viewed as an acute health condition often resulting in lethal opportunistic infections and early death, the advent of multiple anti-HIV regimens has moved HIV/AIDS into the realm of chronic manageable disease. This transition to a chronic illness brings a new and emerging set of health concerns associated with persons living with HIV/AIDS. One example is the increasing risk of hepatitis co-infection for persons living with HIV/AIDS.

Social workers do not have to become
experts in genetics, but they will need to start incorporating genetic thinking and genetic principles in their practices. Social workers should be able to include genetic information in family histories; understand basic genetics terminology and patterns of inheritance; know how and when to make referrals to genetic counselors and genetic clinics; and understand the psychological, ethical, and social implications of genetic services.

Currently, social workers in health care help clients and their families cope with
acute, chronic, or terminal illnesses, and manage issues that may impede recovery or rehabilitation. They also provide informational and referral services to family caregivers, counsel clients, and help plan
for clients’ needs after discharge by arranging for home health services—from meals-on-wheels to oxygen equipment.
Some social workers participate on
interdisciplinary teams that evaluate particular geriatric or organ transplant clients. The health-related settings where
social workers provide social services are now governed by managed care organizations.
Because of the presence of managed
care, social workers in health care often must grapple with ethical issues (Flynn, 2000; Reamer, 1999) surrounding the realities of cost containment, short-term intervention expectations, ambulatory and community-based care, and greater decentralization of services.

This update describes the results of the
second Practice Research Network (PRN II)
survey conducted by the National Association
of Social Workers (NASW) as a collaborative
project funded by the Center for Substance
Abuse Treatment (CSAT), Substance Abuse
and Mental Health Services Administration
(SAMHSA). The PRN II survey objectives
were to develop broad knowledge about
social workers’ practices, along with more
specific knowledge about social workers who
provide substance abuse treatment services.
The focus of this update, however, will be the
PRN II survey data relevant to social workers
who provide mental health services.

The following is a short list of Web-based resources that are useful for policy and practice issues. Some have archived Webcasts of Congressional briefings or testimony;
others allow one to communicate directly with policymakers. There are hundreds more, and we invite you to comment and add to this list so that it can be a resource for members of the health section.

In a recent article I imparted general information on how elder abuse is a current national dilemma. Since then, the well-publicized Special Committee on Aging (March 1, 2002) indicates that the federal government is beginning to give more attention to victimized elderly people. The staggering statistics of the
annually increasing reports signify that more needs to be done on all levels. This article focuses on awareness and practice techniques that social workers can use to help mitigate the suffering of elderly people who are being victimized.

In 1987 the federal government created definitions of elder abuse, neglect, and exploitation as part of the Amendments to the Older Americans Act. Abuse now requires mandatory reporting. However, there are no specific laws to protect this group. There are three basic categories of elder abuse: (1)domestic elder abuse, (2)institutional elder abuse, and (3)selfneglect (NCEA, 2002).

The data for this report was drawn from membership information and informed by the NASW Practice Research Network (PRN) Survey, 2000. Conducted in the spring of 2000, the NASW PRN survey captured demographic and practice data
from a random sample of 2000 regular NASW members. Because of the sampling techniques and the high response rate (81 percent), which minimized potential for selectivity and non-response bias, these results are highly representative of NASW membership.

It is always hard to lose a parent. It is especially hard when you lose a parent toward whom you have had negative or ambivalent feelings. Mourning such a parent is much more complex grieving the loss of a parent with whom you had a loving and positive relationship. There is a profound sense of sadness and loss about something one never had. You have lost a
parent with whom your relationship was
not good. There is no longer the chance to
improve the relationship and to win
acceptance and love. Many grown children
who have come for counseling over the death of a difficult parent have told us that their sadness is mostly over the lost opportunities.